중환자 말초신경근육병증 환자에서 일측 하부 뇌신경 침범: 증례 보고
Critical Illness Neuromyopathy Involving the Unilateral Lower Cranial Nerves: A Case Report
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Critical illness neuromyopathy (CINM) manifests as weakness of the limbs and failure to wean from the ventilator as a complication of critical illness. It increases hospital mortality and causes chronic disability. Electrodiagnostic studies for CINM show both distal axonal sensory-motor polyneuropathy and myopathic motor unit action potentials. Invasion of the cranial nerves is unusual. We report the case of a patient who had CINM with left 11 and 12 cranial nerve palsies. A 62-year-old male patient received intensive care unit care for 21 days due to acute decompensated heart failure. His clinical features were weakness of the upper and lower extremities, decreased deep tendon reflex, tongue deviation, and atrophy of the left sternocleidomastoid and trapezius muscles. On electrophysiological studies, the compound motor action potentials of the left trapezius muscles were lower than those of the right trapezius muscles. The left upper trapezius and genioglossus muscles also clearly showed abnormal spontaneous activity.
Abstract
Critical illness neuromyopathy (CINM) manifests as weakness of the limbs and failure to wean from the ventilator as a complication of critical illness. It increases hospital mortality and causes chronic disability. Electrodiagnostic studies for CINM show both distal axonal sensory-motor polyneuropathy and myopathic motor unit action potentials. Invasion of the cranial nerves is unusual. We report the case of a patient who had CINM with left 11 and 12 cranial nerve palsies. A 62-year-old male patient received intensive care unit care for 21 days due to acute decompensated heart failure. His clinical features were weakness of the upper and lower extremities, decreased deep tendon reflex, tongue deviation, and atrophy of the left sternocleidomastoid and trapezius muscles. On electrophysiological studies, the compound motor action potentials of the left trapezius muscles were lower than those of the right trapezius muscles. The left upper trapezius and genioglossus muscles also clearly showed abnormal spontaneous activity.
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