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What are the differences between CIP and CIM?
CIP is often difficult to clinically distinguish from CIM
What is Critical Illness Polyneuropathy (CIP)?
Critical Illness Polyneuropathy is an acute length-dependent sensorimotor axonal polyneuropathy most often associated with sepsis and multiorgan system failure occurring after days to weeks of illness onset.
What is Critical Illness Myopathy (CIM)?
Critical Illness Myopathy is an acute rapidly progressive myopathy most often seen in patients with sepsis and multiorgan system failure who are exposed to high-dose steroids and neuromuscular blocking agents (NMBAs) and occurs after days to weeks of illness onset.
Difference between Critical Illness Polyneuropathy and Critical Illness Myopathy
Condition | Incidence | Clinical Features | ENMG Findings | Serum CK | Muscle Biopsy | Treatment | Prognosis |
---|---|---|---|---|---|---|---|
CIP | Common | Flaccid limbs; respiratory weakness | Axonal degeneration of motor and sensory fibers | Nearly normal | Denervation atrophy | Supportive, treat sepsis and avoid hyperglycemia | Variable |
CIM | Common with steroids (NMBAs), and sepsis | Flaccid limbs; respiratory weakness | Abnormal spontaneous activity | Mildly elevated | Loss of thick (myosin) filaments | Supportive Judicious with high-dose steroids and NMBAs | Good |
NMBAs , Neuromuscular blocking agents; CK , creatinine kinase.
Sources
From Bolton CF: Neuromuscular manifestations of critical illness. Muscle Nerve 32(2):140-163, 2005.