ORIGINAL ARTICLE

Critical illness neuromuscular disease: clinical, electrophysiological, and prognostic aspects

B Tabarki¹, A Coffiniéres², P Van den Bergh¹, G Huault², P Landrieu² and G Sébire¹

¹ Service de neuropédiatrie et service de neurologie, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200 Brussels, Belgium
² Service de neuropédiatrie et service de réanimation infantile, Hôpital Bicêtre, Université Paris-Sud, 78 rue du Général Leclerc 94275, Le Kremlin-Bicêtre, France

Correspondence to:
Correspondence to:
Dr B Tabarki, Service de Neuropédiatrie, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200 Brussels, Belgium;
bmlaiki{at}excite.fr

Background: Critical illness neuromuscular disease, which has been recognised as a distinct clinical entity in adults, remains poorly described in children.

Aims: To assess retrospectively the clinical, electrophysiological, and prognostic features of the disease.

Methods: Retrospective study in a children's university hospital.

Results: Five critically ill patients presented with generalised paralysis, associated with long lasting failure to breathe in three. The cause of the generalised paralysis was critical illness neuropathy in two, acute myopathy in two, and mixed neuromyopathy in one.

Conclusions: Neuromuscular disease should be suspected in critically ill children with muscle weakness. Because corticosteroids and muscle relaxants appear to trigger some types of intensive care unit neuromuscular disease in children, their use should be restricted or administered at the lowest doses possible.

Keywords: critical illness; polyneuropathy; myopathy

Abbreviations: CK, creatine kinase; CSF, cerebrospinal fluid; EMG, electromyography; ICU, intensive care unit

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