Acute neuromuscular failure acquired in the community: A state-of-the-art review

Abstract

Acute neuromuscular failure (ANF) has become a common issue in emergency rooms worldwide. A systematic research was done in multiple data sources. A total of 350 articles were found, exclusion criteria were: not-neurological acute respiratory failure, case reports, duplication, and written in languages other than English or Spanish. One hundred and six abstracts of articles that included definition, epidemiology, etiology, physiopathology, and ANF diagnosis were considered, 70 were re-viewed. Finally, 32 articles focused on decision-making by non-neurological medical staff were taken. Guillain-Barré syndrome seems to be the most common etiology for ANF in Mexico. Myasthenia gravis, autoimmune and oncologic diseases are also common causes for ANF. The clinical signs for an imminent neuromuscular failure are drop head, faltering speech, nasal voice, and sialorrhea. Early diagnosis of ANF leads to better ANF outcomes; it is necessary to establish an approach for the diagnosis in Mexico.