Critical illness polyneuropathy

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Critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) are overlapping syndromes of widespread muscle weakness and neurological dysfunction that can develop in critically ill patients receiving intensive care. CIP was first described by Dr. Charles F. Bolton in a series of five patients.[1] CIP and CIM have similar symptoms and presentations and are often distinguished largely on the basis of specialized electrophysiologic testing or muscle and nerve biopsy.[2] The causes of CIP and CIM are unknown, though they are thought to be a possible neurological manifestation of systemic inflammatory response syndrome.[3] Corticosteroids and neuromuscular blocking agents, which are widely used in intensive care, may contribute to the development of CIP and CIM,[4] as may elevations in blood sugar, which frequently occur in critically ill patients.[5]


  1. ^ Bolton; Gilbert; Hahn; Sibbald (November 1984). "Polyneuropathy in critically ill patients". J Neurol Neurosurg Psychiatry 47 (11): 1223–31. doi:10.1136/jnnp.47.11.1223. PMC 1028091. PMID 6094735. 
  2. ^ Maramattom BV, Wijdicks EF (2006). "Acute neuromuscular weakness in the intensive care unit". Crit. Care Med. 34 (11): 2835–41. doi:10.1097/01.CCM.0000239436.63452.81. PMID 16932235. 
  3. ^ Visser LH (2006). "Critical illness polyneuropathy and myopathy: clinical features, risk factors and prognosis". Eur. J. Neurol. 13 (11): 1203–12. doi:10.1111/j.1468-1331.2006.01498.x. PMID 17038033. 
  4. ^ Schweickert WD, Hall J (2007). "ICU-acquired weakness". Chest 131 (5): 1541–9. doi:10.1378/chest.06-2065. PMID 17494803. 
  5. ^ Hermans G, Wilmer A, Meersseman W et al. (2007). "Impact of intensive insulin therapy on neuromuscular complications and ventilator dependency in the medical intensive care unit". Am. J. Respir. Crit. Care Med. 175 (5): 480–9. doi:10.1164/rccm.200605-665OC. PMID 17138955.