| Electrophysiological
Studies in the Critical Care Unit: Investigating Polyneuropathies
Robert
Chen
Abstract:
Polyneuropathies frequently contribute to ventilator dependency
and prolonged stay in the intensive care unit. As clinical examination
is often limited in critically ill patients, electrophysiological
studies are invaluable in establishing the diagnosis of neuropathy,
determining its pathophysiology, severity and in following the
patients' progression. Guillain-Barré syndrome (GBS)
developing before intensive care unit admission and critical
illness polyneuropathy (CIP) developing as a complication of
sepsis and multiorgan failure are the commonest causes of neuropathy.
Electrophysiological findings in CIP are that of an axonal neuropathy
whereas the findings in GBS are usually consistent with a demyelinating
neuropathy. Axonal GBS can be distinguished from CIP by the
preceding illnesses, slow nerve conduction velocity in some
cases, lack of spontaneous activity on the initial needle electromyographic
study and cerebrospinal fluid findings.
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Can.
J. Neurol. Sci. 1998; 25: S32 - S35
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