Reversible paralysis with status asthmaticus, steroids, and pancuronium: Clinical electrophysiological correlates

• Published in: Muscle & nerve Vol. 20; no. 12; pp. 1587 - 1590
• Main Authors: Road, Jeremy, Mackie, Gordon, Jiang, Tian-Xi, Stewart, Heather, Eisen, Andrew
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 01.12.1997; Wiley
• Subjects: Adult; asthmatics; Biological and medical sciences; Diseases of striated muscles. Neuromuscular diseases; electromyogram; Electromyography; Female; Glucocorticoids - therapeutic use; Humans; Male; Medical sciences; Methylprednisolone - therapeutic use; Middle Aged; Muscles - drug effects; Muscles - physiopathology; Neurology; neuromuscular blockade; Neuromuscular Blocking Agents - adverse effects; Neuromuscular Blocking Agents - therapeutic use; Pancuronium - therapeutic use; paralysis; Status Asthmaticus - physiopathology; Status Asthmaticus - therapy; steroids; Human; Steroid; Nervous system diseases; Neuromuscular diseases; Motor system disorder; Artificial ventilation; Asthma; Neuromuscular blocking agent; Striated muscle disease; Complication; Electromyography; Paralysis; Myopathy
• ISSN: 0148-639X; 1097-4598
• DOI: 10.1002/(SICI)1097-4598(199712)20:12<1587::AID-MUS15>3.0.CO;2-Y

Prolonged neuromuscular weakness has been identified after neuromuscular blockade in intensive care unit patients on mechanical ventilation. Previously reported electromyographic studies in these patients documented both neurogenic features and features consistent with a myopathy. We recorded sequential electrophysiological parameters during recovery from neuromuscular blockade in 5 patients with clinical weakness. An evolving pattern was identified. The early features were in keeping with previous reports of neurogenic changes, and this evolved into features consistent with a primary myopathy. Several potential underlying mechanisms are discussed. © 1997 John Wiley & Sons, Inc. Muscle Nerve 20: 1587–1590, 1997