Markedly prolonged compound muscle action potential duration in a patient with coronavirus disease 2019 related critical illness myopathy

IF 0.4 Q4 CLINICAL NEUROLOGY Neurology and Clinical Neuroscience Pub Date : 2023-02-13 DOI:10.1111/ncn3.12703

Y. Mizoi, Kei Ikeda, M. Sonoo, Y. Hatanaka, Toshimasa Yamamoto

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Abstract

A 56‐year‐old man admitted with coronavirus disease 2019 (COVID‐19) became severely ill, required ventilator support and intensive care unit management. After ventilator weaning, he was found to have quadriparesis. Guillain–Barré syndrome (GBS) was suspected and administration of high‐dose intravenous immunoglobulin (IVIg) was considered. However, markedly prolonged compound muscle action potential (CMAP) duration was observed, leading to a diagnosis of critical illness myopathy (CIM). Therefore, IVIg was not given at all, and supportive care was continued. A good functional recovery was obtained. Prolonged CMAP duration is a characteristic finding to CIM. CIM following severe COVID‐19 infection is probably common, although the diagnostic value of prolonged CMAP duration is not widely recognized. This characteristic finding deserves more attention because it contributes to early differentiation between CIM and GBS and the use of IVIg in patients with COVID‐19 may cause thrombotic complications and worsen the prognosis.

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一名2019冠状病毒病相关危重症肌病患者的复合肌肉动作电位持续时间显著延长

一名56岁的男子因2019冠状病毒病（COVID-19）入院，病情严重，需要呼吸机支持和重症监护室管理。在停用呼吸机后，他被发现患有四肢瘫痪。怀疑格林-巴利综合征（GBS），并考虑给予高剂量静脉注射免疫球蛋白（IVIg）。然而，观察到复合肌肉动作电位（CMAP）持续时间显著延长，从而诊断为危重症肌病（CIM）。因此，完全没有给予IVIg，并继续提供支持性护理。获得了良好的功能恢复。延长CMAP持续时间是CIM的一个特征性发现。严重COVID-19感染后的CIM可能很常见，尽管延长CMAP持续时间的诊断价值尚未得到广泛认可。这一特征性发现值得更多关注，因为它有助于CIM和GBS之间的早期区分，并且在COVID-19患者中使用IVIg可能会导致血栓并发症并恶化预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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