Critical Illness Polyneuropathy in Children with Infectious Diseases

Abstract

Our goal was to establish electrophysiological features of critical illness polyneuropathy in children with infectious diseases. Materials and Methods: We evaluated peripheral nervous system involvement in 67 critically ill children, admitted in ICU with different types of infectious diseases (viral encephalitis, meningoencephalitis, meningitis, acute gastroenteritis). Age of the group varied from 4 months to 17 years. All patients underwent conduction studies and neurological investigation. Sensory and motor fibers of n. ulnaris et n. medianus, motor fibers of n. Tibialis and sensory fibers of n. Suralis were tested. Lowering of the amplitudes, conduction velocity slowing and asymmetry were accounted for the motor and sensory fibers. Results: In 47 cases (n=71) diagnosis of critical illness polyneuropathy (CIP) was established. Lesions mostly involved lower limbs nerves. According to our data, severe course of CIP was seen in 40% of all cases. Average time of CIP onset in children was 5-7 days from the beginning of mechanical ventilation. Conclusions: Critical illness polyneuropathy in children with infectious diseases is a severe condition which may lead to the disability of the patients. Average time of its onset is the 5-7 days from the beginning of the mechanical ventilation in 71% of the patients. More often sensory and motor fibers of lower limbs nerves are affected. Conduction studies is a valuable tool in diagnostic process in establishing the critical illness polyneuropathy in children with infectious diseases. Keywords: Critical illness, critical illness polyneuropathy, children, electromyography.