Critical illness myopathy (CIM)
Critical illness myopathy most commonly occurs in patients who have received intravenous glucocorticoids in the ICU setting. Patients have severe muscle weakness, preserved reflexes/sensation, and difficulty weaning off a ventilator. Half of the patients have an elevated CK.
Clinical presentation, serum CK levels, electrodiagnostic testing, and muscle biopsy findings can separate patients with CIP from those with CIM; however, it is not uncommon for both conditions to coexist in the same individual. Treatment is supportive care, limiting the use of glucocorticoids and paralytics, and nutritional support. Patients usually take weeks to months to recover their strength.
