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The discovery of critical illness polyneuropathy

Published online by Cambridge University Press:  01 February 2008

C. F. Bolton
C. F. Bolton*
Affiliation:
Queen’s University, Department of Medicine, Canada
*
Correspondence to: Charles F. Bolton, Etherington Hall, Room 3008, 94 Stuart Street, Kingston, Ontario, CanadaK7L 3N6. E-mail: CB41@post.queensu.ca; Tel: +1 613 533 2865; Fax: +1 613 533 6695
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Summary

In 1892 Osler described ‘rapid loss of flesh’ in prolonged sepsis. Thereafter, for years, limb weakness was attributed to cachectic myopathy, and difficulty weaning from mechanical ventilation was attributed to diaphragmatic fatigue. In 1961 Mertens described ‘coma-polyneuropathies’, and in 1971 Henderson and colleagues described polyneuropathy in patients with burns. In 1984 Bolton and colleagues, in a series of reports, defined the clinical, electrophysiological and morphological features of septic encephalopathy and critical illness polyneuropathy. Evidence suggested that polyneuropathy was due to the ‘toxic’ effects of sepsis. Polyneuropathy was a common cause of difficulty in weaning when lung and cardiac cause had been excluded. Since 1984, cases of critical illness polyneuropathy have been reported from several countries. Moreover, a number of investigators reported instances of critical illness myopathy. Comprehensive studies by Latronico and colleagues indicated that polyneuropathy and myopathy often occurred together in the same patient. With successful treatment of sepsis, improvement often occurred in encephalopathy, polyneuropathy and myopathy, except in very severe cases.

Keywords

POLYNEUROPATHYCRITICAL CAREMUCULAR DISEASESNEUROMUSCULAR DISEASESSEPSIS
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue S42 , February 2008 , pp. 66 - 67
Copyright
Copyright © European Society of Anaesthesiology 2008

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