CIM

Q: The Critical Illness Myopathy (CIM) affects which group of muscles more? - select one

A) distal 

B) proximal 

Answer: B

CIM, although it causes flaccid quadriparesis, usually affects the proximal muscles more. It is also associated with facial muscle weakness.

A pure exclusive CIM can be distinguished from Critical Illness Polyneuropathy (CIP) by normal sensation and normal or attenuated deep tendon reflexes. Patients with exclusive CIM grimace to pain even when they are encephalopathic.

Unfortunately, most patients suffer from combined CIP and CIM.

#ICU-course

#neurology

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. Z'Graggen WJ, Tankisi H. Critical Illness Myopathy. J Clin Neurophysiol. 2020 May;37(3):200-204. doi: 10.1097/WNP.0000000000000652. PMID: 32358245.

3. Rodriguez B, Larsson L, Z'Graggen WJ. Critical Illness Myopathy: Diagnostic Approach and Resulting Therapeutic Implications. Curr Treat Options Neurol. 2022;24(4):173-182. doi: 10.1007/s11940-022-00714-7. Epub 2022 Mar 28. PMID: 35370393; PMCID: PMC8958813.

4. Friedrich O. Critical illness myopathy: what is happening? Curr Opin Clin Nutr Metab Care. 2006 Jul;9(4):403-9. doi: 10.1097/01.mco.0000232900.59168.a0. PMID: 16778569.