[Electrophysiologic studies in polyneuropathy of intensive care patients]

Abstract

Polyneuropathy of the critically ill patient has gained attention in recent years. The symptoms of muscle weakness and impaired somatosensory perception are more obvious for the observer and recognizable for the conscious patient, if heavy long-term sedation is avoided. The cause of polyneuropathy remains unclear and diagnostic findings are still rare and partly controversial. In five of our patients with multiorgan failure and clinical signs of muscle weakness, cortical somatosensory evoked potentials (SEP) and the evoked electromyogram (EMG) were recorded simultaneously after the stimulation of mixed peripheral nerves to test the functional integrity of the efferent and afferent neuronal pathways. We observed different degrees of SEP and EMG alterations, which were more pronounced in the lower than in the upper extremities and which may be explained by an axonal degeneration. Such a process may be caused by multiple factors and pathophysiological mechanisms. An influence of neostigmine on a reduced EMG response could not be found.