Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 24 , ISSUE 2 ( February, 2020 ) > List of Articles

CASE REPORT

An Unusual Case of Critical Illness Polyneuromyopathy

Gaurav Chaudhary

Keywords : Diabetic Ketoacidosis, Intravenous immunoglobulin, Quadriplegia, Severe hypokalemia

Citation Information : Chaudhary G. An Unusual Case of Critical Illness Polyneuromyopathy. Indian J Crit Care Med 2020; 24 (2):133-135.

DOI: 10.5005/jp-journals-10071-23346

License: CC BY-NC 4.0

Published Online: 01-02-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Critical illness myopathy (CIM), critical illness polyneuropathy (CIP), and critical illness polyneuromyopathy (CIPNM) are the group of disorders that are commonly presented as neuromuscular weakness in intensive care unit (ICU) settings. They are responsible for prolonged ICU stay and failure to wean off from mechanical ventilation. We report a case of young female who was admitted with undiagnosed type I diabetes mellitus with diabetic ketoacidosis, severe hypokalemia, sepsis developed acute onset quadriplegia, and diaphragmatic palsy within 72 hours of ICU admission. On detailed investigation, CIPNM was diagnosed. In view of high morbidity, mortality, and poor prognosis, a guided approach to diagnose and treat in earliest possible duration might give better improvement and outcome of the illness. Despite all the odds, our patient showed good clinical improvement and finally got discharged.


  1. Shepherd S, Batra A, Lerner DP. Review of critical illness myopathy and neuropathy. Neurohospitalist 2017;7(1):41–48. DOI: 10.1177/1941874416663279.
  2. Zhou C, Wu L, Ni F, Ji W, Wu J, Zhang H. Critical illness polyneuropathy and myopathy: a systematic review. Neural regeneration research 2014;9(1):101–110. DOI: 10.4103/1673-5374.125337.
  3. Appleton R, Kinsella J. Intensive care unit-acquired weakness. Continuing education in anaesthesia, critical care and pain 2012;12(2):62–66. DOI: 10.1093/bjaceaccp/mkr057.
  4. Bolton CF. Neuromuscular manifestations of critical illness. Muscle Nerve 2005;32(2):140–163. DOI: 10.1002/mus.20304.
  5. Mohr M, Englisch L, Roth A, Burchardi H, Zielmann S. Effects of early treatment with immunoglobulin on critical illness polyneuropathy following multiple organ failure and gram-negative sepsis. Intensive Care Med 1997;23(11):1144–1149. DOI: 10.1007/s001340050471.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.