Critical illness polyneuromyopathy in septic patients: Is it possible to diagnose it in a bedside clinical examination?

Abstract:

OBJECTIVE:To determine the sensitivity and specificity of peripheral and respiratory muscle strength tests in diagnosing critical illness polyneuromyopathy (CIPNM), compared with an electrophysiological examination. METHODS:Fifty septic patients who required mechanical ventilation for at least five days, and without a previous history of muscle weakness, were included. Peripheral muscle strength was assessed using the Medical Research Council (MRC) score, handgrip strength by dynamometry, and respiratory muscle strength with maximum respiratory pressures. Diagnosis of CIPNM was either confirmed or rejected by an electrophysiological examination. Receiver operating characteristic curve analysis was performed to determine the cut-off values with the best sensitivity (SN) and specificity (SP) of the studied variables in the presence or absence of CIPNM. RESULTS:Patients with CIPNM were older, more critical (APACHE IV/SAPS 3), had a longer hospitalization, required mechanical ventilation for longer, and had a higher rate of intensive care unit readmission. Cutoff values identified CIPNM patients using MRC scores, dynamometry according to sex, maximal expiratory and inspiratory pressures, as well as being confirmed by the electrophysiological examination, with good sensitivity and specificity: < 40 (SN: 0.893; SP: 0.955); < 7 kg (SN: 1; SP: 0.909) for men, < 4 kg (SN: 0.882; SP: 1) for women; < 34 cmH2O (SN: 0.808; SP: 0.909) and > -40 cmH2O (SN: 0.846; SP: 0.909), respectively. CONCLUSION:The MRC score, dynamometry or maximum respiratory pressures can be used to identify patients with CIPNM at the intensive care bedside assessment. The healthcare professional can choose any of the methods studied to evaluate the patient, based on his experience and the resource available.

journal_name

Arq Neuropsiquiatr

authors

Schmidt D,Coelho AC,Vieira FN,Torres VF,Savi A,Vieira SRR

doi

10.1590/0004-282X20180144

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

33-38

issue

1

eissn

0004-282X

issn

1678-4227

pii

S0004-282X2019000100033

journal_volume

77

pub_type

杂志文章
  • Syringohydromyelia associated to therapeutic procedures for severe forms of neurocysticercoses: case report.

    abstract::Syringohydromyelia is defined as a longitudinal dilatation of the central canal of the spinal cord with accumulated cerebrospinal fluid. This condition may cause neurologic deficits when the cavity enlarges and compresses the spinal cord. We present the case of a 33 years-old female with progressive paraparesis caused...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x2004000500029

    authors: Honorato D,Borges W,Vargas AA,Ramina R

    更新日期:2004-09-01 00:00:00

  • Cortical projection of the inferior choroidal point as a reliable landmark to place the corticectomy and reach the temporal horn through a middle temporal gyrus approach.

    abstract:OBJECTIVE:To establish preoperatively the localization of the cortical projection of the inferior choroidal point (ICP) and use it as a reliable landmark when approaching the temporal horn through a middle temporal gyrus access. To review relevant anatomical features regarding selective amigdalohippocampectomy (AH) for...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/0004-282x20140165

    authors: Frigeri T,Rhoton A,Paglioli E,Azambuja N

    更新日期:2014-10-01 00:00:00

  • [Anatomo-pathological and ultrastructural features of mucopolysaccharidosis. Case report].

    abstract::The mucopolysaccharidoses (MPS) are lysosomal storage diseases in which a specific enzyme defect causes glycosaminoglycans storage in tissues. The authors present a necropsy case of a 10 years old boy with clinical and laboratorial diagnosis of MPS. The necropsy revealed thickening of meninges, cardiac valves and hepa...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x1997000100018

    authors: Torres LF,De Noronha L,Jacob GV,Antoniuk S

    更新日期:1997-03-01 00:00:00

  • Correlation between fatigue and self-esteem in patients with multiple sclerosis.

    abstract:OBJECTIVE:To assess the possible association of fatigue with self-esteem in multiple sclerosis (MS) patients. METHOD:Thirty patients were prospectively assessed. None of them presented moderate or severe depression or anxiety and their degree of disability was low (EDSS

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x2009000500007

    authors: Fragoso YD,Silva EO,Finkelsztejn A

    更新日期:2009-09-01 00:00:00

  • Primary headache subtypes and thyroid dysfunction: Is there any association?

    abstract:BACKGROUND:Primary headaches, and particularly migraine and tension-type headache (TTH) as well as hypothyroidism are common medical conditions. To date, numerous studies have suggested a possible bidirectional relationship between migraine and hypothyroidism, although certain studies had contradictory results. OBJECT...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/0004-282X20200070

    authors: Spanou I,Christidi F,Liakakis G,Rizonaki K,Bougea A,Anagnostou E,Kararizou E

    更新日期:2020-11-01 00:00:00

  • Prevalence of oropharyngeal dysphagia in hereditary spastic paraplegias.

    abstract:OBJECTIVES:Hereditary spastic paraplegias (HSP) are a group of genetic diseases characterized by lower limb spasticity with or without additional neurological features. Swallowing dysfunction is poorly studied in HSP and its presence can lead to significant respiratory and nutritional complications. The aim of this stu...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章,多中心研究

    doi:10.1590/0004-282X20190180

    authors: Jacinto-Scudeiro LA,Machado GD,Ayres A,Burguêz D,Polese-Bonatto M,González-Salazar C,Siebert M,França Junior MC,Olchik MR,Saute JAM

    更新日期:2019-12-01 00:00:00

  • Supplementation and therapeutic use of vitamin D in patients with multiple sclerosis: consensus of the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology.

    abstract::Multiple sclerosis (MS) is an inflammatory, autoimmune, demyelinating, and degenerative central nervous system disease. Even though the etiology of MS has not yet been fully elucidated, there is evidence that genetic and environmental factors interact to cause the disease. Among the main environmental factors studied,...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 共识发展会议,杂志文章

    doi:10.1590/0004-282X20130252

    authors: Brum DG,Comini-Frota ER,Vasconcelos CC,Dias-Tosta E

    更新日期:2014-02-01 00:00:00

  • Neuronosology: historical remarks.

    abstract::Classifications for neurological disorders have evolved from following the theory of the humors to modern anatomical pathology and, recently, to the germ theory that stared the etiological era, as seen in book content lists. The symptomatic approach towards neuronosology was widely used until the middle of the 19(th) ...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 历史文章,杂志文章

    doi:10.1590/s0004-282x2011000400028

    authors: Gomes Mda M

    更新日期:2011-06-01 00:00:00

  • A diagnostic approach for neurodegeneration with brain iron accumulation: clinical features, genetics and brain imaging.

    abstract::Neurodegeneration with brain iron accumulation (NBIA) represents a heterogeneous and complex group of inherited neurodegenerative diseases, characterized by excessive iron accumulation, particularly in the basal ganglia. Common clinical features of NBIA include movement disorders, particularly parkinsonism and dystoni...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章,评审

    doi:10.1590/0004-282X20160080

    authors: Salomão RP,Pedroso JL,Gama MT,Dutra LA,Maciel RH,Godeiro-Junior C,Chien HF,Teive HA,Cardoso F,Barsottini OG

    更新日期:2016-07-01 00:00:00

  • Headache among medical and psychology students.

    abstract:UNLABELLED:Headaches occur frequently and thus are a key component of sociocentric medical education. OBJECTIVE:To study headaches among students of medicine and psychology in a single university. METHOD:This was a questionnaire-based survey of a cohort of students of medicine and psychology. RESULTS:The overall lif...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x2011000400018

    authors: Ferri-de-Barros JE,Alencar MJ,Berchielli LF,Castelhano Junior LC

    更新日期:2011-06-01 00:00:00

  • [Bayonet finger and the use of illicit drugs].

    abstract::Prevalence of "bayonet finger", a semiologic sign of attention deficit and hyperactivity disorder (ADHD), was determined in male illicit drug users, admitted in psychiatric hospital. A control group, paired in sex, age and social status, was built from the general population. The sign was observed en 165/345 (47.8%) d...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:

    authors: Borini P

    更新日期:2001-06-01 00:00:00

  • Headache is associated with lower alcohol consumption among medical students.

    abstract::The aim of this study was to investigate the association between headache and alcohol consumption among medical students. 480 medical students were submitted to a questionnaire about headaches and drinking alcohol. Headache was assessed by ID-Migraine and functional disability was evaluated with MIDAS. The evaluation ...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x2011000500009

    authors: Domingues RB,Domingues SA

    更新日期:2011-08-01 00:00:00

  • [Precipitating factors of migraine attacks in patients with migraine without aura].

    abstract::To study the distribution of triggers of migraine in a selected population, 100 patients who fulfilled the diagnostic criteria for migraine without aura as proposed by the International Headache Society were evaluated by means of a personal interview. Stress was the most cited trigger, triggering migraine in 76%. Afte...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:

    authors: Ierusalimschy R,Moreira Filho PF

    更新日期:2002-09-01 00:00:00

  • [Diagnosis and treatment of the most frequent vestibular syndromes].

    abstract::The aims of this study were to identify the most common vestibular syndromes in a dizziness unit, and to observe their clinical aspects and response to treatment. Five hundred and fifteen patients were studied retrospectively in two institutions. Aspects of anamnesis, physical examination and the response to treatment...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x2005000100025

    authors: Kanashiro AM,Pereira CB,Melo AC,Scaff M

    更新日期:2005-03-01 00:00:00

  • [Aneurysm of the anterior inferior cerebellar artery: case report].

    abstract::The intracranial aneurysms of the posterior circulation have been reported between 5 and 10% of all cerebral aneurysms and the aneurysms of the anterior inferior cerebellar artery (AICA) are considered rare, can cause cerebello pontine angle (CPA) syndrome with or without subarachnoid hemorrhage. Since 1948 few cases ...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章,评审

    doi:10.1590/s0004-282x2002000600026

    authors: Adorno JO,de Andrade GC

    更新日期:2002-12-01 00:00:00

  • [Sacral agenesis associated with a teratoma].

    abstract::A case of a 29-year-old male with a huge sacrococcygeal teratoma completely removed by surgery, and associated with a sacral agenesis is reported. Roentgenograms revealed fusion of the T12, L1, L2, and L3 vertebral bodies, absence of the left 12th rib, partial agenesis of sacrococcygeal elements and a lumbar scoliosis...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x1987000100011

    authors: Borges AC,Festugato RR,de Cerqueira JC,de Souza MR

    更新日期:1987-03-01 00:00:00

  • Nervous system cancer mortality in an industrialized area of Brazil 1980-1993.

    abstract:OBJECTIVES:The industrialization process and nervous system cancer (NSC) mortality in a urban region of Brazil. METHOD:From registries of the State System of Data Analysis Foundation (SEADE), 103 males deaths by NSC (ICD-9) in Baixada Santista (BS), from 1980 to 1993 were selected. Mortality ratios were calculated com...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x2000000300003

    authors: Medrado-Faria MD,de Almeida JW,Zanetta DM,Gattás GJ

    更新日期:2000-06-01 00:00:00

  • [Nonfuntional pituitary adenomas: evaluation of 36 patients].

    abstract::We present our experience with 36 cases of nonfunctional pituitary adenomas. These tumors were divided into non reactive and inactive in agreement with the immunohistochemical study. They present with visual symptoms, mainly bitemporal hemianopsia; they were macroadenomas, either invasive or non invasive, in both grou...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x2002000100021

    authors: Tella OI Jr,Herculano MA,Delcello R,Aguiar PH

    更新日期:2002-03-01 00:00:00

  • [Clinical and laboratory changes before the development of delirium tremens].

    abstract::Thirteen alcoholic male patients that developed delirium tremens (DT) after admission in a psychiatric hospital for treatment of alcoholism (group I) had their clinical and laboratorial records examined. The laboratory samples were taken during the phase previous at the DT. Data on this group were compared to those of...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x1997000100008

    authors: Borini P,da Silva CO

    更新日期:1997-03-01 00:00:00

  • Frontopolar and anterior temporal cortex activation in a moral judgment task: preliminary functional MRI results in normal subjects.

    abstract:OBJECTIVE:To study the brain areas which are activated when normal subjects make moral judgments. METHOD:Ten normal adults underwent BOLD functional magnetic resonance imaging (fMRI) during the auditory presentation of sentences that they were instructed to silently judge as either "right" or "wrong". Half of the sent...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x2001000500001

    authors: Moll J,Eslinger PJ,Oliveira-Souza R

    更新日期:2001-09-01 00:00:00

  • Dementia pugilistica with clinical features of Alzheimer's disease.

    abstract::A 61-year-old ex-boxer presented with a three-year history of progressive memory decline. During a seven-year follow-up period, there was a continuous cognitive decline, very similar to that usually observed in Alzheimer's disease. Parkinsonian, pyramidal or cerebellar signs were conspicuously absent. Neuropathologica...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x2007000500019

    authors: Areza-Fegyveres R,Rosemberg S,Castro RM,Porto CS,Bahia VS,Caramelli P,Nitrini R

    更新日期:2007-09-01 00:00:00

  • [Paracoccidioidomycosis of the central nervous system: case report].

    abstract::The involvement of the central nervous system in paracoccidioidomycosis is more frequent than previously thought. The first reference to the possibility that Paracoccidioides brasiliensis could affect the central nervous system was by Pereira & Jacobs in 1919. Since then, a great number of other studies has showed thi...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x2000000400024

    authors: da Silva CE,Cordeiro AF,Gollner AM,Cupolilo SM,Quesado-Filgueiras M,Curzio MF

    更新日期:2000-09-01 00:00:00

  • [Ventriculoperitoneal shunt infections in children and adolescents with hydrocephalus].

    abstract:OBJECTIVE:To determine frequency, etiology, site and clinical and laboratory findings of ventriculoperitoneal shunt (VPS) infections in children and adolescents with hydrocephalus managed in Hospital Governador João Alves Filho, Aracaju SE, Brazil. METHOD:A non-controlled prospective observational study comprising 50 ...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x2007000100024

    authors: Lima MM,Pereira CU,Silva AM

    更新日期:2007-03-01 00:00:00

  • [Intracranial saccular aneurysm: report of 3 cases in a same family].

    abstract::The authors report the cases of three patients from the same family, all with intracranial saccular aneurysm (left carotid artery, anterior communicating artery, and middle cerebral artery). All three patients were operated on with good recovery and no complications. The authors call attention for some etiopathogenic ...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x1992000400018

    authors: Pinto JR,Godoy JM,Telles CR,Faria CS,Avelar MV,Nicaretta DH

    更新日期:1992-12-01 00:00:00

  • Differences in walking attainment ages between low-risk preterm and healthy full-term infants.

    abstract:OBJECTIVE:To compare gross motor development of preterm infants (PT) without cerebral palsy with healthy full-term (FT) infants, according to Alberta Infant Motor Scale (AIMS); to compare the age of walking between PT and FT; and whether the age of walking in PT is affected by neonatal variables. METHODS:Prospective s...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x2012000800007

    authors: Restiffe AP,Gherpelli JL

    更新日期:2012-08-01 00:00:00

  • Magnetic resonance imaging in five patients with a tumefactive demyelinating lesion in the central nervous system.

    abstract::Five patients with a tumefactive lesion were clinically followed from 1992 to 1993. Four patients were female; age ranged from 32 to 57 years, the duration of symptoms varied from 3 days to 3 years. Neurological examination disclosed dementia in two patients, aphasia in three, hemiparesis in four, hemihypoaesthesia in...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x1999000600004

    authors: Silva HC,Callegaro D,Marchiori PE,Scaff M,Tsanaclis AM

    更新日期:1999-12-01 00:00:00

  • Clinical and morphological study of calf enlargement following S-1 radiculopathy.

    abstract::Calf enlargement following sciatica is a rare condition. It is reported the case of a 28-year-old woman who complained of repeated episodes of lower back pain radiating into the left buttock and foot. One year after the beginning of her symptoms, she noticed enlargement of her left calf. X-ray studies disclosed L5-S1 ...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x1992000300021

    authors: Nascimento OJ,De Freitas MR,Hahn MD,Araújo AQ

    更新日期:1992-09-01 00:00:00

  • Iatrogenic Creutzfeldt-Jakob disease following human growth hormone therapy: case report.

    abstract::We report the case of a 41-year-old man with iatrogenic Creutzfeldt-Jakob disease (CJD) acquired after the use of growth hormone (GH) obtained from a number of pituitary glands sourced from autopsy material. The incubation period of the disease (from the midpoint of treatment to the onset of clinical symptoms) was rat...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x2002000300022

    authors: Caboclo LO,Huang N,Lepski GA,Livramento JA,Buchpiguel CA,Porto CS,Nitrini R

    更新日期:2002-06-01 00:00:00

  • [De novo absence status: case report].

    abstract::There are few descriptions about middle-aged patients who have nonconvulsive status epilepticus, absence status. We reported the clinical case of a woman, 52-year-old, diabetic, referred to the emergency room in a confusional state. Initial electroencephalogram showed continuous typical, bilateral, symmetric and synch...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x1997000400022

    authors: Tedrus GM,Fonseca LC,De Tella LM,Viana MA

    更新日期:1997-09-01 00:00:00

  • Carpal tunnel syndrome in the elderly: nerve conduction parameters.

    abstract:OBJECTIVE:To establish nerve conduction parameters for carpal tunnel syndrome (CTS) electrodiagnosis in the elderly. METHOD:Thirty healthy subjects (65-86 years), 9 male and 21 female, were studied. Routine median and ulnar sensory and motor nerve conduction studies, median mixed palmar latency, comparative latency te...

    journal_title:Arquivos de neuro-psiquiatria

    pub_type: 杂志文章

    doi:10.1590/s0004-282x2010000100019

    authors: Naves TG,Kouyoumdjian JA

    更新日期:2010-02-01 00:00:00