Table 2.
Patient | Age | Sex | ICU stay | Clinical features | Laboratory findings (peak levels) | NCS/EMG: time since disease onset | Sensory NCS | Motor NCS | EMG | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
CK | CRP | IL-6 | D-dimer | WBC | Lymphocyte | SNAP amplitude | sNCV | CMAP amplitude | CMAP duration | DML | mNCV | Proximal muscles* | ||||||
[weeks] | [U/l] | [mg/l] | [pg/ml] | [mg/l] | [×103/μl] | [×103/μl] | [weeks] | [μV] | [m/s] | [mV] | [ms] | [ms] | [m/s] | |||||
40–220 | <0.8 | <7.0 | <0.5 | 3.6–10.5 | 1.1–4.5 | |||||||||||||
1 | 77 | M | 6 | Proximal weakness and muscle wasting in upper more than lower limbs; myalgia; fatigue | 4,002 | 15.9 | 225.2 | 1.5 | 10.1 | 2.8 | 7 | L median: 15.2 | 50 | L median: 4.2 | 9.3 | 3.9 | 48 | Myopathic |
R ulnar: 12.4 | 48 | R ulnar: 5.7 | 13.7 | 2.9 | 55 | |||||||||||||
R sural: 6.3 | 47 | L peroneal: 2.1 | 7.3 | 3.1 | 40 | |||||||||||||
R tibial: 2.4 | 4.2 | 4.0 | 41 | |||||||||||||||
2 | 58 | M | 3 | Predominantly proximal weakness in four limbs; hyporeflexia; myalgia | 6,732 | 17.1 | 343.6 | 2.1 | 9.9 | 4.6 | 4 | L median: 22.5 | 49 | L median: 3.9 | 9.0 | 3.8 | 48 | Myopathic |
R ulnar: 25.8 | 51 | R ulnar: 4.8 | 8.7 | 2.5 | 50 | |||||||||||||
R sural: 9.5 | 48 | L peroneal: 1.2 | 6.5 | 4.0 | 39 | |||||||||||||
R tibial: 2.2 | 6.7 | 4.1 | 40 |
Laboratory data were obtained during intensive care. Clinical and electrodiagnostic data were obtained during neurorehabilitation.
M, male; F, female; ICU, intensive care unit; CK, creatine kinase; CRP, C-reactive protein; WBC, white blood cell count; IL, interleukin; NCS, nerve conduction study; EMG, electromyography; SNAP, sensory nerve action potential; sNCV, sensory nerve conduction velocity; CMAP, compound muscle action potential; DML, distal motor latency; mNCV, motor nerve conduction velocity; R, right; L, left.
The upper limits of normality (mean + 2 SD) for distal CMAP duration using a low frequency filter of 2 Hz are: median nerve = 7.3 ms, ulnar nerve = 7.5 ms, peroneal nerve = 7.3 ms, tibial nerve = 6.8 ms (12); abnormal values are marked in bold.
Left deltoid, right triceps brachii, left iliopsoas, and right rectus femoris muscles.