- Dedication
- Preface
- Acknowledgments
- 1 A 35-Year-Old Man with Progressive Left-Hand Weakness
- 2 A 54-Year-Old Male with Right-Hand Weakness
- 3 A 50-Year-Old Male with Speech, Swallowing, and Behavioral Difficulties
- 4 A 45-Year-Old Male with Toxin Exposure
- 5 A 48-Year-Old with Progressive Weakness and Pain
- 6 A 30-Year-Old Male Requiring Management of Progressive Weakness
- 7 A 61-Year-Old Male with Severe Shoulder and Cervical Pain
- 8 A 55-Year-Old Male with Right Foot Weakness
- 9 A 63-Year-Old Male with Severe Flaccid Weakness Post Motor Vehicle Accident
- 10 A 55-Year-Old Female with Slowly Progressive Weakness
- 11 A 40-Year-Old Female with Balance Problems and Numbness After Bariatric Surgery
- 12 A 55-Year-Old Female with a History of Right Foot Drop and Left Hand Weakness
- 13 A 40-Year-Old Female with Increasing Arm Pain and Numbness
- 14 A 59-Year-Old Man with Progressive Difficulties with Balance and Weight Loss
- 15 A 68-Year-Old Male with Progressive Numbness and Gait Difficulties
- 16 A 28-Year-Old Male with Weakness in the Setting of Cancer
- 17 A 44-Year-Old Man with Bilateral Facial Droop
- 18 A 41-Year-Old Male with Foot Drop and Malaise
- 19 A 44-Year-Old Female with Buttock Pain
- 20 A 50-Year-Old Woman with Burning Feet
- 21 A 56-Year-Old Woman with Small-Fiber Neuropathy and Progressive Leg Pain and Weakness
- 22 A 34-Year-Old Male with Possible Myopathic Process
- 23 A 39-Year-Old Man with Low Back Pain and Scapular Winging
- 24 A 52-Year-Old Female with Weakness and Droopy Eyelids
- 25 A 20-year-Old Male with Acute Lower-Extremity Weakness
- 26 A 19-Year-Old Male with Stiffness and Weakness After Waking
- 27 A 68-Year-Old Female with Progressive Pain and Weakness
- 28 An 18-Year-Old Male with Slowly Progressive Weakness
- 29 A 30-Year-Old Male with Severe Cramps
- 30 A 72-Year-Old Female with Facial Weakness and Droopy Eyelids
- 31 An 80-Year-Old Myasthenia Gravis Patient with Worsening Weakness
- 32 A 44-Year-Old Male with Subacute Onset of Syncope
- 33 A 46-Year-Old Man with Double Vision and Proximal Leg Weakness
- 34 A 2-Month-Old Boy with Acute Diffuse Weakness
- Index
(p. 49) A 63-Year-Old Male with Severe Flaccid Weakness Post Motor Vehicle Accident
- Chapter:
- (p. 49) 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
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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- Dedication
- Preface
- Acknowledgments
- 1 A 35-Year-Old Man with Progressive Left-Hand Weakness
- 2 A 54-Year-Old Male with Right-Hand Weakness
- 3 A 50-Year-Old Male with Speech, Swallowing, and Behavioral Difficulties
- 4 A 45-Year-Old Male with Toxin Exposure
- 5 A 48-Year-Old with Progressive Weakness and Pain
- 6 A 30-Year-Old Male Requiring Management of Progressive Weakness
- 7 A 61-Year-Old Male with Severe Shoulder and Cervical Pain
- 8 A 55-Year-Old Male with Right Foot Weakness
- 9 A 63-Year-Old Male with Severe Flaccid Weakness Post Motor Vehicle Accident
- 10 A 55-Year-Old Female with Slowly Progressive Weakness
- 11 A 40-Year-Old Female with Balance Problems and Numbness After Bariatric Surgery
- 12 A 55-Year-Old Female with a History of Right Foot Drop and Left Hand Weakness
- 13 A 40-Year-Old Female with Increasing Arm Pain and Numbness
- 14 A 59-Year-Old Man with Progressive Difficulties with Balance and Weight Loss
- 15 A 68-Year-Old Male with Progressive Numbness and Gait Difficulties
- 16 A 28-Year-Old Male with Weakness in the Setting of Cancer
- 17 A 44-Year-Old Man with Bilateral Facial Droop
- 18 A 41-Year-Old Male with Foot Drop and Malaise
- 19 A 44-Year-Old Female with Buttock Pain
- 20 A 50-Year-Old Woman with Burning Feet
- 21 A 56-Year-Old Woman with Small-Fiber Neuropathy and Progressive Leg Pain and Weakness
- 22 A 34-Year-Old Male with Possible Myopathic Process
- 23 A 39-Year-Old Man with Low Back Pain and Scapular Winging
- 24 A 52-Year-Old Female with Weakness and Droopy Eyelids
- 25 A 20-year-Old Male with Acute Lower-Extremity Weakness
- 26 A 19-Year-Old Male with Stiffness and Weakness After Waking
- 27 A 68-Year-Old Female with Progressive Pain and Weakness
- 28 An 18-Year-Old Male with Slowly Progressive Weakness
- 29 A 30-Year-Old Male with Severe Cramps
- 30 A 72-Year-Old Female with Facial Weakness and Droopy Eyelids
- 31 An 80-Year-Old Myasthenia Gravis Patient with Worsening Weakness
- 32 A 44-Year-Old Male with Subacute Onset of Syncope
- 33 A 46-Year-Old Man with Double Vision and Proximal Leg Weakness
- 34 A 2-Month-Old Boy with Acute Diffuse Weakness
- Index