extraocular muscles in CIM

Q: In Critical Illness Myopathy (CIM), the presence of extraocular muscle weakness is diagnostic.

A) True

B) False

Answer: B

CIM has a few characteristic features:

• Flaccid quadriparesis 
• Proximal muscles are affected more than distal muscles.
• Ventilatory failure
• Facial muscle weakness (may or may not present)
• Sparing of extraocular muscles (very rarely involved)
• Intact sensation*
• Intact deep tendon reflexes*

*feature of Critical Illness Polyneuropathy (CIP)

References:

1. Latronico N, Rasulo FA, Eikermann M, Piva S. Illness Weakness, Polyneuropathy and Myopathy: Diagnosis, treatment, and long-term outcomes. Crit Care. 2023 Nov 13;27(1):439. doi: 10.1186/s13054-023-04676-3. Erratum in: Crit Care. 2023 Nov 30;27(1):469. doi: 10.1186/s13054-023-04757-3. PMID: 37957759; PMCID: PMC10644573.

2. Hermans G, Van den Berghe G. Clinical review: intensive care unit acquired weakness. Crit Care. 2015 Aug 5;19(1):274. doi: 10.1186/s13054-015-0993-7. PMID: 26242743; PMCID: PMC4526175.