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Electrophysiological tests in intensive care

Published online by Cambridge University Press:  01 February 2008

M. Botteri  and
B. Guarneri
M. Botteri*
Affiliation:
Spedali Civili di Brescia, Piazza Spedali Civili, *Servizio di Anestesia e Rianimazione, Italy
B. Guarneri
Affiliation:
Spedali Civili di Brescia, Piazza Spedali Civili, Servizio di Neurofisiopatologia Brescia, Italy
*
Correspondence to: Marco Botteri, 2° Servizio di Anestesia e Rianimazione Spedali Civili di Brescia, Piazza Spedali Civili, 1 25123 Brescia, Italy. E-mail: [email protected]; Tel: +39 030 3995764; Fax: +39 030 3995570
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Summary

Neuromuscular complications encountered in intensive care can be due to peripheral nerves (polyneuropathies), muscles (myopathies), neuromuscular end-plate (transmission deficit) or a combination of these. Neurophysiopathological tests that enable us to diagnose and maybe differentiate between these causes are essentially electroneurographs and electromyographs. These assess, either directly or indirectly, the integrity of the peripheral system, both sensory (centripetal afferent pathways) and motor (lower motor neurones, neuromuscular junction, muscle membrane and contractile substrate). Electrical activity in the muscle is measured using a special device (an electromyograph) comprising preamplifiers, a computer with special programmes and algorithms for analysing, digitalizing, amplifying and filtering the recorded signal and a monitor on which to visualize the on-line trace. The machine also has speakers. These serve to recognize and identify the physiological events being recorded as they make such unusual, individual sounds. An electric stimulator with constant current can be used to stimulate branches of superficial nerves (motor, sensory or mixed) so that electric conduction speed can be studied and the sensory or motor response analysed. The results can be saved on a hard disc or on any magnetic or digital support, viewed off-line or even printed.

Keywords

POLYNEUROPATHYCRITICAL CAREMUSCULAR DISEASESNEUROMUSCULAR DISEASESELECTROMYOGRAPHYNERVE CONDUCTION
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue S42 , February 2008 , pp. 174 - 180
Copyright
Copyright © European Society of Anaesthesiology 2008

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References

1.Bolton, CF. Neuromuscular conditions in the intensive care unit. Intensive Care Med 1996; 22: 841–843.CrossRefGoogle ScholarPubMed
2.Lacomis, D, Petrella, T, Giuliani, MJ. Causes of neuromuscular weakness in the intensive care unit: a study of ninety-two patients. Muscle Nerve 1998; 21: 610–617.3.0.CO;2-B>CrossRefGoogle ScholarPubMed
3.Coacley, JH, Nagendran, K, Yarwood, GD et al. . Patterns of neurophysiological abnormality in prolonged critical illness. Intensive Care Med 1998; 24: 801–807.CrossRefGoogle Scholar
4.De Jonghe, B, Cook, D, Sharhar, T et al. . Acquired neuromuscular disorders in critically ill patients: a systematic review. Intensive Care Med 1998; 24: 1242–1250.CrossRefGoogle ScholarPubMed
5.Latronico, N, Candiani, A. Neuromuscular abnormalities in patients with organ failure and sepsis. Intensive Care Med 1994; 20: 612–613.CrossRefGoogle ScholarPubMed
6.Latronico, N, Fenzi, F, Recupero, D et al. . Critical illness myopathy and neuropathy. Lancet 1996; 347: 1579–1582.CrossRefGoogle ScholarPubMed
7.Gutmann, L, Gutmann, L. Critical illness neuropathy and myopathy. Arch Neurol 1999; 56: 527–528.CrossRefGoogle ScholarPubMed
8. Kimura J. Electrodiagnosis in disease of nerve and muscle: principes and practice. In: Davis FA, ed. Principles of Nerve Conduction Studies. Philadelphia, USA, 2001.Google Scholar
9. Lenman JAR, Ritche AE. Elettromiografia clinica. Raffaello cortina editore, 1983.Google Scholar
10.Van Dijk, GJ, Van Benten, I, Kramer, CGS et al. . CMAP amplitude cartography of innervated by the median, ulnar, peroneal and tibial nerves. Muscle Nerve 1999; 22: 273–389.3.0.CO;2-2>CrossRefGoogle ScholarPubMed
11.Johnson, EW, Olsen, KJ. Clinical value of motor nerve conduction velocity determination. JAMA 1960; 172: 2030–2035.CrossRefGoogle ScholarPubMed
12.Bolton, CF, Laverty, DA, Brown, JD et al. . Critically ill polyneuropathy: electrophysiological studies and differentiation from Guillain–Barre syndrome. J Neurol Neurosurg Psychiatry 1986; 49: 563–573.CrossRefGoogle ScholarPubMed
13.Olney, RK, Aminoff, MJ. Electrodiagnostic features of the Guillain–Barre syndrome: the relative sensitivity of different techniques. Neurology 1990; 40: 471–475.CrossRefGoogle ScholarPubMed
14. Berne R, Levi MN. Trasmissione sinaptica. In: Fisiologia. Milano, Italy: Casa EA, ed. Ambrosiana, 1989: 52–70.Google Scholar
15. Berne R, Levi MN. Il muscolo come tessuto. In: Fisiologia. Milano, Italy: Casa EA, ed. Ambrosiana, 1989: 402–419.Google Scholar
16.Latronico, N. Neuromuscular alterations in the critically ill patient: critical illness myopathy, critical illness neuropathy, or both? Intensive Care Med 2003; 29: 1411–1413.CrossRefGoogle ScholarPubMed
17.Bednarik, J, Lukas, Z, Vondracek, P. Critical illness polyneuromyopathy: the electrophysiological components of a complex entity. Intensive Care Med 2003; 29: 1505–1514.CrossRefGoogle ScholarPubMed
18.Tennila, A, Salmi, T, Pettila, V et al. . Early signs of critical illness polyneuropathy in ICU patients with systemic inflammatory response syndrome or sepsis. Intensive Care Med 2000; 26: 1360–1363.CrossRefGoogle ScholarPubMed
19.Rich, MM, Teener, JW, Raps, EC et al. . Muscle is electrically inexcitable in acute quadriplegic myopathy. Neurology 1996; 46: 731–736.CrossRefGoogle ScholarPubMed
20.Rich, MM, Bird, SJ, Raps, EC et al. . Direct muscle stimulation in acute quadriplegic myopathy. Muscle Nerve 1997; 20: 665–673.3.0.CO;2-6>CrossRefGoogle ScholarPubMed
21.Trojaborg, W, Weimer, LH, Hays, AP. Electrophysiologic studies in critical illness associated weakness: myopathy or neuropathy – a reappraisal. Clin Neurophysiol 2001; 112: 1586–1593.CrossRefGoogle ScholarPubMed
22.Lefaucheur, JP, Nordine, T, Rodriguez, P et al. . Origin of ICU acquired paresis determined by direct muscle stimulation. J Neurol Neurosurg Psychiatry 2006; 77: 500–506.CrossRefGoogle ScholarPubMed