Differences between Critical Illness Polyneuropathy and Critical Illness Myopathy

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

ConditionIncidenceClinical FeaturesENMG FindingsSerum CKMuscle BiopsyTreatmentPrognosis
CIPCommonFlaccid limbs; respiratory weaknessAxonal degeneration of motor and sensory fibersNearly normalDenervation atrophySupportive, treat sepsis and avoid hyperglycemiaVariable
CIMCommon with steroids (NMBAs), and sepsisFlaccid limbs; respiratory weaknessAbnormal spontaneous activityMildly elevatedLoss of thick (myosin) filamentsSupportive
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.

15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856