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A 63-Year-Old Male with Severe Flaccid Weakness Post Motor Vehicle Accident 

A 63-Year-Old Male with Severe Flaccid Weakness Post Motor Vehicle Accident
Chapter:
A 63-Year-Old Male with Severe Flaccid Weakness Post Motor Vehicle Accident
Author(s):

Jeffrey A. Cohen

, Justin J. Mowchun

, Victoria H. Lawson

, and Nathaniel M. Robbins

DOI:
10.1093/med/9780190491901.003.0009
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date: 15 January 2021

Neuromuscular disorders are important causes of newly acquired weakness in the intensive care unit. Although evaluation usually begins with physical examination findings, these can be compromised in the intensive care unit environment. Therefore, electrodiagnostic study becomes even more important as a tool in localizing weakness to nerve, muscle or neuromuscular junction. Critical illness neuropathy and myopathy occurs in the setting of sepsis and multiple organ failure where sepsis is accompanied by the systemic inflammatory response syndrome. Additional, intensive care unit-specific risk factors exist, predominantly relating to administration of high-dose steroids, nondepolarizing neuromuscular blocking agents, and sedating agents such as propofol. There is no specific treatment except for optimizing medical management of the underlying disorder, including prevention and management of sepsis, systemic inflammatory response syndrome, and organ damage, as well as avoidance of exacerbating medications.

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