Small-nerve-fiber pathology in critical illness documented by serial skin biopsies
| Authors | |
|---|---|
| Year of publication | 2015 |
| Type | Article in Periodical |
| Magazine / Source | Muscle & nerve |
| MU Faculty or unit | |
| Citation | |
| Doi | http://dx.doi.org/10.1002/mus.24489 |
| Field | Neurology, neurosurgery, neurosciences |
| Keywords | critical illness; small fibers; polyneuropathy; myopathy; skin biopsy |
| Attached files | |
| Description | Introduction: Small fiber pathology can develop in the acute phase of critical illness and may explain chronic sensory impairment and pain in critical care survivors. Methods: Eleven adult ischemic stroke patients in a neurocritical care unit were enrolled in an observational cohort study. Intraepidermal never fiber density (IENFD) in the distal leg was assessed on admission to the intensive care unit and 10-14 days later, together with electrophysiological testing. Results: Of the 11 patients recruited, 9 (82%) had sepsis or multiple organ failure. Median IENFD on admission (5.05 fibers/mm) decreased significantly to 2.18 fibers/mm (P <0.001), and abnormal IENFD was found in 8 patients (72.7%). Electrodiagnostic signs of large fiber neuropathy and/or myopathy were found in 6 patients (54.5%), and autonomic dysfunction was found in 2 patients (18.2%). Discussion: Serial IENFD measurements confirmed the development of small fiber sensory involvement in the acute phase of critical illness. |
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