CIM

Q: Critical Illness Myopathy (CIM) affects more? (select one)

 A) proximal muscles
 B) distal muscles


Answer: A

CIM is very common and still an under-recognized disease in ICU. After few days in ICU, it may become the most common cause of failure to wean from mechanical ventilation. The most common presenting symptom is flaccid quadriparesis which affects proximal more than distal muscles. Facial muscle weakness is also common but usually, go undiagnosed. The best differential diagnosis is due to the fact that this facial weakness mostly spares extraocular muscle.

#criticalillness



References:

1. Lacomis D, Giuliani MJ, Van Cott A, Kramer DJ. Acute myopathy of intensive care: clinical, electromyographic, and pathological aspects. Ann Neurol 1996; 40:645. 

2. Latronico N, Peli E, Botteri M. Critical illness myopathy and neuropathy. Curr Opin Crit Care 2005; 11:126. 

3. Deconinck N, Van Parijs V, Beckers-Bleukx G, Van den Bergh P. Critical illness myopathy unrelated to corticosteroids or neuromuscular blocking agents. Neuromuscul Disord 1998; 8:186.

4. Lacomis D, Zochodne DW, Bird SJ. Critical illness myopathy. Muscle Nerve 2000; 23:1785.