[Critical illness polyneuropathy in a patient with Parkinson disease: a case report and review of the literature].
OBJECTIVE
To report a case of critical illness polyneuropathy (CIP) with Parkinson disease and discuss the development, clinical features and early diagnosis of this condition.


METHODS
The clinical data of a patient with CIP and Parkinson's disease and the relevant literature were reviewed.


RESULTS
This case showed no typical disease course of sepsis, and the condition exacerbated rapidly. The patient presented initially with abnormal homeostasis, followed by rapid onset of respiratory muscle weakness to require mechanical ventilation, but no limb weaknesses were detected. Intravenous antibiotics and aggressive treatment of sepsis did not produce any positive responses to wean from mechanical ventilation. Examinations of creatine kinase and cerebrospinal fluid showed no abnormalities. Electromyography and nerve conduction studies demonstrated declined nerve conduction velocity and decreased sensory and motor muscle action potentials, suggesting the possibility of CIP.


CONCLUSIONS
In patients with Parkinson disease, the occurrence of sepsis with prolonged mechanical ventilation and limb weakness indicates the necessity of neurophysiological examination, muscle biopsies and laboratory tests, which may help detect CIP in the early phase. Proper interventions of sepsis may reduce the likeliness of CIP. Elimination of the risk factors and aggressive management of sepsis can be effective measures for preventing CIP.
Department of Neurology, Southern Medical University, Guangzhou, China. tansheng18@126.com
Sheng
S
Tan
Jian
J
Chen
Rui-qing
RQ
Chen
Hui
H
Liu
Yang
Y
Guo
Can
C
Li
Ma-hui
MH
Zhang
Zhen-zhou
ZZ
Chen
D000368:Aged; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000150:complications*; D011115:Polyneuropathies / Q000150:complications* / Q000175:diagnosis*; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000150:complications; D018805:Sepsis / Q000150:complications*