Logo of jnnpsycJournal of Neurology, Neurosurgery and PsychiatryVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
J Neurol Neurosurg Psychiatry. 1986 May; 49(5): 563–573.
PMCID: PMC1028811

Critically ill polyneuropathy: electrophysiological studies and differentiation from Guillain-Barré syndrome.


A polyneuropathy of varying severity has been observed in association with sepsis and critical illness in 15 patients. Since clinical evaluation is often difficult, electrophysiological studies provided definitive evidence for polyneuropathy. These revealed reductions in the amplitudes of compound muscle and sensory nerve action potentials, the most marked abnormality. Near-nerve recordings confirmed such reductions for sensory fibres. Needle electromyography revealed signs of denervation of limb muscles. Phrenic nerve conduction and needle electromyographic studies of chest wall muscles suggested that the polyneuropathy partially explained difficulties in weaning patients from the ventilator, an early clinical sign. No defect in neuromuscular transmission was demonstrated, despite the use of aminoglycoside antibiotics in some patients. In those who survived the critical illness, clinical and electrophysiological improvement occurred. The 15 critically ill polyneuropathy patients were compared with 16 Guillain-Barré syndrome patients observed during the same period. The analysis showed that the two polyneuropathies are likely to be separate entities that can be distinguished in most instances by the predisposing illness, electrophysiological features and cerebrospinal fluid results.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.5M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Pine RW, Wertz MJ, Lennard ES, Dellinger EP, Carrico CJ, Minshew BH. Determinants of organ malfunction or death in patients with intra-abdominal sepsis. A discriminant analysis. Arch Surg. 1983 Feb;118(2):242–249. [PubMed]
  • Beisel WR. Mediators of fever and muscle proteolysis. N Engl J Med. 1983 Mar 10;308(10):586–587. [PubMed]
  • Clowes GH, Jr, George BC, Villee CA, Jr, Saravis CA. Muscle proteolysis induced by a circulating peptide in patients with sepsis or trauma. N Engl J Med. 1983 Mar 10;308(10):545–552. [PubMed]
  • Roussos C, Macklem PT. The respiratory muscles. N Engl J Med. 1982 Sep 23;307(13):786–797. [PubMed]
  • Bolton CF, Gilbert JJ, Hahn AF, Sibbald WJ. Polyneuropathy in critically ill patients. J Neurol Neurosurg Psychiatry. 1984 Nov;47(11):1223–1231. [PMC free article] [PubMed]
  • Bolton CF, Carter K, Koval JJ. Temperature effects on conduction studies of normal and abnormal nerve. Muscle Nerve. 1982;5(9S):S145–S147. [PubMed]
  • Bolton CF, Carter KM. Human sensory nerve compound action potential amplitude: variation with sex and finger circumference. J Neurol Neurosurg Psychiatry. 1980 Oct;43(10):925–928. [PMC free article] [PubMed]
  • McLeod JG. Electrophysiological studies in the Guillain-Barré syndrome. Ann Neurol. 1981;9 (Suppl):20–27. [PubMed]
  • Schaumburg HH, Spencer PS. Toxic neuropathies. Neurology. 1979 Apr;29(4):429–431. [PubMed]
  • Brown WF, Feasby TE. Conduction block and denervation in Guillain-Barré polyneuropathy. Brain. 1984 Mar;107(Pt 1):219–239. [PubMed]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Group


Save items

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...