ELECTROPHYSIOLOGICAL STUDIES IN THE CRITICAL CARE UNIT - INVESTIGATING POLYNEUROPATHIES

Polyneuropathies frequently contribute to ventilator dependency and pr olonged stay in the intensive care unit, As clinical examination is of ten limited in critically ill patients, electrophysiological studies a re invaluable in establishing the diagnosis of neuropathy, determining its pathophysiology, severity and in following the patients' progress ion. Guillain-Barre syndrome (GBS) developing before intensive care un it admission and critical illness polyneuropathy (CIP) developing as a complication of sepsis and multiorgan failure are the commonest cause s of neuropathy. Electrophysiological findings iii CIP are that of an axonal neuropathy whereas the findings in GBS are usually consistent w ith a demyelinating neuropathy, Axonal GBS can be distinguished from C IP by the preceding illnesses, slow nerve conduction velocity in some cases, lack of spontaneous activity on the initial needle electromyogr aphic study and cerebrospinal fluid findings.