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Acute Quadriplegic Myopathy Unrelated to Steroids or Paralyzing Agents: Quantitative EMG Studies

Published online by Cambridge University Press:  02 December 2014

Ahmet Höke ,
Douglas W. Zochodne  and
N. B. Rewcastle
Ahmet Höke
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
Douglas W. Zochodne
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
N. B. Rewcastle
Affiliation:
Department and Pathology, University of Calgary, Calgary, Canada
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Abstract

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Background:

Quadriplegic myopathy (QM) and its variants generally are described in critically ill patients who are exposed to steroids and nondepolarizing muscle blocking agents (NDMBAs).

Methods:

A patient with sepsis who was not exposed to steroids or an NDMBA infusion developed QM and was studied using serial quantitative electromyography.

Results:

Clinical and electrophysiological studies identified evidence of a severe myopathy and muscle biopsy showed necrosis, calcifications and selective loss of myosin filaments in non-necrotic fibers. Her clinical recovery paralleled rises in motor unit action potential (MUAP) amplitudes studied by serial automatic decomposition electromyography (ADEMG).

Conclusion:

QM can develop with sepsis and without significant exposure to steroids and NDMBAs. ADEMG can be a useful tool in electrophysiological evaluation of critically ill patients with weakness.

Résumé

RÉSUMÉIntroduction:

La myopathie quadriplégique (MQ) et ses variantes sont généralement décrites chez des patients dont l’état est critique et qui sont exposés à des stéroïdes et à des bloquants musculaires non dépolarisants (BMNDs).

Méthodes:

Une patiente atteinte de septicémie, qui n’avait pas été exposée à des stéroïdes ou à une perfusion de BMND, a développé une MQ. Nous avons procédé chez cette patiente à une étude électromyographique quantitative sériée.

Réltats:

Les études cliniques et électrophysiologiques ont montré des manifestations de myopathie sévère, et à la biopsie musculaire, on a observé une nécrose, des calcifications et une perte sélective des filaments de myosine dans les fibres qui n’étaient pas nécrotiques. Sa récupération Clinique a été parallèle à l’augmentation de l’amplitude des potentiels d’action des unités motrices notée à l’électromyographie de décomposition automatique sériée (ÉMGDA).

Conclusions:

Une MQ peut survenir chez les patients septiques, sans exposition significative à des stéroïdes et à des BMNDs. L’ÉMGDA peut être un outil précieux dans l’évaluation électrophysiologique de patients en état critique qui présentent de la faiblesse musculaire.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 26 , Issue 4 , November 1999 , pp. 325 - 329
Copyright
Copyright © The Canadian Journal of Neurological 1999

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