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Sepsis and the systemic inflammatory response syndrome: neuromuscular manifestations.
Crit Care Med. 1996 Aug; 24(8):1408-16.CC

Abstract

OBJECTIVE

To describe the various conditions of peripheral nerve, neuromuscular junction, and muscle associated with the systemic inflammatory response syndrome (SIRS).

DATA SOURCES

Publications in the scientific literature and personal observations during the last 15 yrs.

DATA EXTRACTION

Computer search of the literature and review of patient records relating to polyneuropathy, neuromuscular transmission defects, and myopathies associated with sepsis, the septic syndrome, and SIRS.

SYNTHESIS

SIRS is a new concept in which infection and trauma induce a systemic inflammatory response affecting the microcirculation to organs throughout the body. The nervous system is commonly affected in the forms of septic encephalopathy and critical illness polyneuropathy. Neuromuscular blocking agents and corticosteroids may have additional toxic effects on the neuromuscular system that are manifest as transient neuromuscular blockade, an axonal motor neuropathy, or a thick filament myopathy. Clinical examination in the critical care unit is often unreliable and electrophysiologic studies, at times accompanied by magnetic resonance imaging of the spinal cord, measurement of the circulating creatine phosphokinase concentration, and muscle biopsy, are often necessary to establish the diagnosis. Variants of critical illness polyneuropathy may occur outside the critical care unit. The precise mechanism of these neuromuscular conditions is not known, and further basic research is needed.

CONCLUSIONS

A variety of neuromuscular conditions complicates SIRS. The identification of these conditions is important in patient management and in rendering a prognosis.

Authors+Show Affiliations

Department of Clinical Neurological Sciences, Victoria Hospital, University of Western Ontario, London, Canada.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

8706499

Citation

Bolton, C F.. "Sepsis and the Systemic Inflammatory Response Syndrome: Neuromuscular Manifestations." Critical Care Medicine, vol. 24, no. 8, 1996, pp. 1408-16.
Bolton CF. Sepsis and the systemic inflammatory response syndrome: neuromuscular manifestations. Crit Care Med. 1996;24(8):1408-16.
Bolton, C. F. (1996). Sepsis and the systemic inflammatory response syndrome: neuromuscular manifestations. Critical Care Medicine, 24(8), 1408-16.
Bolton CF. Sepsis and the Systemic Inflammatory Response Syndrome: Neuromuscular Manifestations. Crit Care Med. 1996;24(8):1408-16. PubMed PMID: 8706499.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sepsis and the systemic inflammatory response syndrome: neuromuscular manifestations. A1 - Bolton,C F, PY - 1996/8/1/pubmed PY - 1996/8/1/medline PY - 1996/8/1/entrez SP - 1408 EP - 16 JF - Critical care medicine JO - Crit Care Med VL - 24 IS - 8 N2 - OBJECTIVE: To describe the various conditions of peripheral nerve, neuromuscular junction, and muscle associated with the systemic inflammatory response syndrome (SIRS). DATA SOURCES: Publications in the scientific literature and personal observations during the last 15 yrs. DATA EXTRACTION: Computer search of the literature and review of patient records relating to polyneuropathy, neuromuscular transmission defects, and myopathies associated with sepsis, the septic syndrome, and SIRS. SYNTHESIS: SIRS is a new concept in which infection and trauma induce a systemic inflammatory response affecting the microcirculation to organs throughout the body. The nervous system is commonly affected in the forms of septic encephalopathy and critical illness polyneuropathy. Neuromuscular blocking agents and corticosteroids may have additional toxic effects on the neuromuscular system that are manifest as transient neuromuscular blockade, an axonal motor neuropathy, or a thick filament myopathy. Clinical examination in the critical care unit is often unreliable and electrophysiologic studies, at times accompanied by magnetic resonance imaging of the spinal cord, measurement of the circulating creatine phosphokinase concentration, and muscle biopsy, are often necessary to establish the diagnosis. Variants of critical illness polyneuropathy may occur outside the critical care unit. The precise mechanism of these neuromuscular conditions is not known, and further basic research is needed. CONCLUSIONS: A variety of neuromuscular conditions complicates SIRS. The identification of these conditions is important in patient management and in rendering a prognosis. SN - 0090-3493 UR - https://www.unboundmedicine.com/medline/citation/8706499/Sepsis_and_the_systemic_inflammatory_response_syndrome:_neuromuscular_manifestations_ L2 - https://dx.doi.org/10.1097/00003246-199608000-00022 DB - PRIME DP - Unbound Medicine ER -