Vecuronium-associated axonal motor neuropathy: a variant of critical illness polyneuropathy?

Neuromuscular blocking agents are routinely used as an adjunct therapy for critically ill patients. Unlike many neuromuscular blocking agents, vecuron ium does not cause significant histamine release, which may lead to broncho constriction. Due to a short duration of action and limited accumulation, v ecuronium has been widely used. Prolonged ventilatory dependence due to per sistent neuromuscular blockade has been reported in patients treated with v ecuronium. We report a case of an 8-year-old girl who had a primarily motor axonopathy presenting with weakness after extended vecuronium administrati on with prolonged course of recovery. This primarily motor neuropathy with axonal features may be a variant of critical illness polyneuropathy, a rare ly reported condition in pediatric patients. (C) 2001 Elsevier Science B.V. All rights reserved.