Reversible Visual Involvement in Critical Illness Polyneuropathy

Abstract

We hereby describe a 3-year-old boy who developed severe fulminant sepsis with the need of urgent intubation, ventilation, and inotropic support. He was admitted to the pediatric intensive care unit where he was initially ventilated for 10 days. Extubation failed, so he was reventilated for further 10 days. Neuromuscular blocking agents, inotropes, steroids, and broad-spectrum antibiotics, including aminoglycosides, were all used. Weakness of all limbs was noticed on day 7. This was associated with visual disturbances. He was diagnosed as having critical illness polyneuropathy and myopathy (CIP/CIM). His outcome was favorable. This case report highlights the unique combination of CIP/CIM features associated with visual impairment and also suggests that full recovery is possible for this clinical presentation.

Keywords

polyneuropathy - myopathy - critical illness

• References

• 1 Kukreti V, Shamim M, Khilnani P. Intensive care unit acquired weakness in children: critical illness polyneuropathy and myopathy. Indian J Crit Care Med 2014; 18 (02) 95-101
• 2 Williams S, Horrocks IA, Ouvrier RA, Gillis J, Ryan MM. Critical illness polyneuropathy and myopathy in pediatric intensive care: a review. Pediatr Crit Care Med 2007; 8 (01) 18-22
• 3 Adamovic T, Willems A, Vanasse M. , et al. Critical illness polyneuromyopathy in a child with severe demyelinating myelitis. J Child Neurol 2009; 24 (06) 758-762
• 4 Vondracek P, Bednarik J. Clinical and electrophysiological findings and long-term outcomes in paediatric patients with critical illness polyneuromyopathy. Eur J Paediatr Neurol 2006; 10 (04) 176-181
• 5 Ohto T, Iwasaki N, Ohkoshi N. , et al. A pediatric case of critical illness polyneuropathy: clinical and pathological findings. Brain Dev 2005; 27 (07) 535-538