Four children with critical illness neuromuscular disease following prolonged dependency on a ventilator are reported from the Departments of Neurology and Pediatrics, West Virginia University Health Sciences Center, Morgantown, and the Department of Medicine (Neurology), Memorial University of Newfoundland, St John’s, Canada. One patient, a 15-year-old boy with septic shock, required ventilatory support and intermittent vecuronium for neuromuscular blockade. Extubation on day 8 was unsuccessful because of quadriparesis, with diffuse muscle atrophy, and absent reflexes. Muscle strength gradually returned over 3 months, but hyporeflexia persisted for > 1 year. [1]
COMMENT. Critical-illness polyneuropathy, a complication of sepsis in adults, and a cause of difficulty in weaning from the ventilator, is covered in Progress in Pediatric Neurology II, 1994, pp275-276. The syndrome appears to be unusual in children.