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Prodromal conditions
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Sepsis, multiple organ failure, etc.
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Gastrointestinal or respiratory infection
|
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Clinical presentation
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Onset of the disorder usually after ICU admission;
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Onset of the disorder usually before ICU admission;
|
|
Often be characterized by fairly symmetric limb muscle weakness sparing cranial nerves;
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Infections precede the onset of progressive weakness and sensory disturbances;
|
|
Sensory deficits less prominent
|
Frequent cranial nerve involvement
|
|
CSF
|
Usually normal
|
Albumino-cytologic dissociation
|
|
Electrophysiology
|
Axonal motor & sensory polyneuropathy
|
1. Demyelinating polyneuropathy or unresponsive nerves, abundant spontaneous activity
|
|
2. Axonal motor & sensory polyneuropathy
|
|
MRI
|
No significant findings
|
Occasional enhancement of spinal nerve roots
|
|
Biopsy
|
Primarily axonal degeneration of distal peripheral nerves without inflammation
|
Primarily demyelinating process with inflammation, or motor/sensory axonal degeneration, or motor axonal degeneration only
|
|
Treatment
|
No specific therapy, usually anti-septic treatment
|
Plasmapheresis, intravenous immune globulin
|
|
Outcome
|
Recovery may be spontaneous and of variable timing; 50% of patients with full recovery
|
Usually >75% complete recovery
|
