A review of the neurological complications of sepsis from the University of Western Ontario, London, and Queen’s University, Kingston, Ontario, Canada, draws attention to “critical-illness polyneuropathy” as a cause of difficulty in weaning from the ventilator. Patients with major medical, surgical, or traumatic illnesses who are in the recovery phase of septic encephalopathy may develop respiratory difficulties as an early sign of polyneuropathy. Electrophysiological studies, showing reduction of diaphragmatic action potential and denervation of chest wall muscles, may be diagnostic of the neuropathy before weakness of limbs and areflexia develop. In contrast to the central nervous system, damage to the peripheral nervous system is more severe and sometimes persistent in the septic syndrome. [1]
COMMENT. In addition to encephalopathy and polyneuropathy, patients with sepsis may develop myositis or myopathy and an elevated CPK. The EEG and EMG are sensitive indicators of these complications of the septic syndrome.