Acute quadriplegia with delayed onset and rapid recovery. Case report

Journal of Neurosurgery
Nicola LatronicoA Candiani

Abstract

The authors describe a patient with severe head injury and sepsis who became acutely quadriplegic 3 days postinjury because of a critical illness polyneuropathy (CIP) and critical illness myopathy (CIM), which resolved rapidly after treatment of the underlying infection. In only 3 days the patient developed septic shock together with flaccid quadriplegia and absent deep tendon reflexes with no clinical or radiological evidence of central nervous system deterioration. Neurophysiological studies showed an acute axonal sensorimotor polyneuropathy, whereas the clinical course strongly suggested a concurrent myopathy. A severe Staphylococcus epidermidis infection accompanied by bacteremia was treated and the patient recovered fully within a few days. Although the case described here is unique because of its very early onset and rapid resolution, CIP and CIM are frequent complications of sepsis and multiple organ failure. The authors suggest that severely head injured patients with sepsis should be evaluated for CIP and CIM when presenting with unexplained muscle weakness or paralysis.

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Citations

Sep 15, 2007·Critical Care Medicine·Bernard De JongheUNKNOWN Groupe de Réflexion et d'Etude des Neuromyopathies en Réanimation
Feb 6, 2010·Critical Care Medicine·Leigh Ann Callahan, Gerald S Supinski
Dec 31, 2010·Indian Journal of Anaesthesia·Mohan GurjarBanani Poddar
Sep 11, 2014·Neural Regeneration Research·Chunkui ZhouHongliang Zhang
May 29, 2004·Current Opinion in Critical Care·Bernard De JongheHervé Outin
Mar 11, 2005·Current Opinion in Critical Care·Nicola LatronicoMarco Botteri
Jul 15, 2005·Current Opinion in Critical Care·Nicola LatronicoElisa Seghelini
Jul 1, 2005·The Journal of Nutrition·Oliver FriedrichErnst Hund

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Methods Mentioned

BETA
sedation
x-ray films
biopsy

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