Zochodne D W, Bolton C F
Department of Clinical Neurosciences, University of Calgary, Alberta, Canada.
Baillieres Clin Neurol. 1996 Oct;5(3):645-71.
Neuromuscular disorders are important causes of prolonged morbidity in intensive care unit. Specific disorders facing the neurologist in the intensive care unit may have been present before admission to the unit or develop as a secondary complication of their stay. A bedside neurological examination, followed by electrophysiological testing, including testing of the respiratory system, is crucial in providing the neuromuscular diagnosis. Among the neuromuscular disorders that confront the clinician in the unit are motor neuron disease, acute polyneuropathies including acute inflammatory demyelinating polyneuropathy (Guillain-Barré syndrome) and critical illness polyneuropathy, neuromuscular transmission disorders including myasthenia gravis, and specific myopathies. This chapter reviews the differential diagnosis and the unique features of neuromuscular conditions that may complicate critical illness and admission to the intensive care unit.
神经肌肉疾病是重症监护病房长期发病的重要原因。重症监护病房中的神经科医生面临的特定疾病可能在患者入院前就已存在，或者在住院期间发展为继发性并发症。床边神经学检查，随后进行包括呼吸系统检测在内的电生理测试，对于做出神经肌肉诊断至关重要。在该病房中临床医生面临的神经肌肉疾病包括运动神经元病、急性多发性神经病（包括急性炎症性脱髓鞘性多发性神经病，即吉兰-巴雷综合征）和危重病性多发性神经病、神经肌肉传递障碍（包括重症肌无力）以及特定的肌病。本章回顾了可能使危重病和入住重症监护病房复杂化的神经肌肉疾病的鉴别诊断及独特特征。
