Bolton C F, Gilbert J J, Hahn A F, Sibbald W J
J Neurol Neurosurg Psychiatry. 1984 Nov;47(11):1223-31. doi: 10.1136/jnnp.47.11.1223.
Five patients developed a severe motor and sensory polyneuropathy at the peak of critical illness (sepsis and multiorgan dysfunction complicating a variety of primary illnesses). Difficulties in weaning from the ventilator as the critical illness subsided and the development of flaccid and areflexic limbs were early clinical signs. However, electrophysiological studies, especially needle electrode examination of skeletal muscle, provided the definite evidence of polyneuropathy. The cause is uncertain, but the electrophysiological and morphological features indicate a primary axonal polyneuropathy with sparing of the central nervous system. Nutritional factors may have played a role, since the polyneuropathy improved in all five patients after total parenteral nutrition had been started, including the three patients who later died of unrelated causes. The features allow diagnosis during life, and encourage continued intensive management since recovery from the polyneuropathy may occur.
五名患者在危重病（脓毒症和多器官功能障碍并发多种原发性疾病）高峰期出现严重的运动和感觉性多发性神经病。随着危重病缓解，脱机困难以及肢体弛缓性和反射消失是早期临床症状。然而，电生理研究，尤其是骨骼肌针电极检查，提供了多发性神经病的确切证据。病因尚不确定，但电生理和形态学特征表明是一种原发性轴索性多发性神经病，中枢神经系统未受累。营养因素可能起了作用，因为在开始全胃肠外营养后，所有五名患者的多发性神经病均有改善，包括三名后来死于无关原因的患者。这些特征有助于生前诊断，并鼓励持续进行强化治疗，因为多发性神经病可能会恢复。
