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Chapter 16 - Electro-biophysiology

Published online by Cambridge University Press:  30 August 2019

Hozefa Ebrahim
Affiliation:
University Hospitals Birmingham Foundation NHS Trust
David Ashton-Cleary
Affiliation:
Royal Cornwall Hospitals NHS Trust
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Summary

A 51-year-old male is admitted via the emergency department after suffering a cardiac arrest and a resulting head injury when he collapsed. Despite arriving in hospital with a stable circulation, he is agitated and very confused. His ECG shows changes consistent with an anterolateral infarction and a CT head does not show any abnormality. He is anaesthetized, undergoes an angioplasty and is admitted to critical care. After failed sedation holds the next day, a CT head is repeated and an EEG is also obtained. The imaging demonstrates cerebral oedema and the EEG shows seizure activity. These are treated medically for a few days and the patient’s consciousness improves. However, during this time, he develops ventilator-associated pneumonia, requiring ventilation for a further week. After this, despite improved neurology, there is difficulty in weaning the patient off the ventilator. He is investigated for critical illness weakness and nerve conduction studies. Electromyography confirms critical illness myopathy. With supportive management and appropriate rehabilitation, he eventually recovers.

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Publisher: Cambridge University Press
Print publication year: 2019

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References

Kinsella, J., Appleton, R.. Intensive care unit-acquired weakness. Continuing Education in Anaesthesia Critical Care & Pain, 12(2), 2012; 6266.Google Scholar

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