好色先生

好色先生

Explore the latest content from across our publications
Join The AAN

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Compound Muscle Action Potential (CMAP) Duration and Myosin Loss in Patients with Critical Illness Myopathy: Correlation and Prognostication
Neuromuscular and Clinical Neurophysiology (EMG)
P1 - Poster Session 1 (8:00 AM-9:00 AM)
11-005
To study the correlation between compound muscle action potential (CMAP) duration and myosin loss and their prognostic values in critical illness myopathy (CIM). 
CIM is a common cause of weakness in critically ill patients. Prolonged CMAP duration and myosin loss are the diagnostic hallmarks of CIM but their correlation  has not been studied. 
We searched the Mayo Clinic database (1986-2021) for patients who developed new weakness during ICU stay or within a month after ICU dismissal, had prolonged CMAP duration and underwent muscle biopsy. Clinical, electrophysiological, and myopathological findings were reviewed.
Twenty patients were identified. Median time of weakness-onset  was 16 days (range: 1-84) since ICU admission.  Muscle biopsy showed myosin loss in 14 patients, 9 of whom had  >50% of myofibers  affected (high grade myosin loss). Type 2 fiber atrophy was observed in 13/14 patients with myosin loss and in 6 patients without myosin loss. Patients with myosin loss had significantly (p≤ 0.05) higher frequency of steroid exposure (14 vs 3), higher median number of necrotic fibers per low power field (2.5 vs 1), and longer median CMAP duration (msec) of peroneal (13.4 vs 8.75), tibial (10 vs 7.8) and ulnar (11.1 vs 7.95) nerves compared to those without myosin loss. Eleven patients had concomitant peripheral neuropathy.  Ten patients died during median follow-up time of 3 months.  The mortality rate was similar in both groups; however, patients with high grade myosin loss had a lower overall survival rate compared to those with low grade or no myosin loss (p=0.05).

Myosin loss occurred in 70% of  CIM patients with prolonged CMAP duration. Longer CMAP duration predicts myosin-loss pathology. The extent of myosin loss directly correlates with the mortality rate. Our findings highlight the potential prognostic values of CMAP duration and myosin-loss severity helping predict disease outcome.

Authors/Disclosures
Shahar Shelly, MD (Rambam Medical Center)
PRESENTER 		Dr. Shelly has or had stock in Remepy.
Pannathat Soontrapa, MD (Siriraj Hospital) The institution of Dr. Soontrapa has received research support from Argenx.
Nicolas Madigan, MD Dr. Madigan has nothing to disclose.
Michael Polzin No disclosure on file
Tarun D. Singh, MBBS Dr. Singh has nothing to disclose.
Sri Raghav S. Sista, MD (UTHouston) Dr. Sista has nothing to disclose.
Pritikanta Paul, MD (University of California, San Francisco) The institution of Dr. Paul has received research support from ZS Associates.
Bing Liao, MD (Houston Methodist Hospital) The institution of Dr. Liao has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenex.
Sherri A. Braksick, MD, FAAN (Mayo Clinic) Dr. Braksick has nothing to disclose.
Andrea Boon, MD (Mayo Clinic) Dr. Boon has received personal compensation in the range of $500-$4,999 for serving as a Consultant for HPE cosmetics .
William J. Litchy, MD, FAAN Dr. Litchy has nothing to disclose.
Margherita Milone, MD, FAAN (Mayo Clinic) Dr. Milone has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cartesian Therapeutics. Dr. Milone has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology Genetics, AAN. The institution of Dr. Milone has received research support from Mayo Clinic, CCaTS-CBD. The institution of Dr. Milone has received research support from Mayo Clinic, SGP Award. The institution of Dr. Milone has received research support from MDA for Care Center grant. The institution of Dr. Milone has received research support from Regenerative medicine Minnesota.
Teerin Liewluck, MD, FAAN (Department of Neurology, Mayo Clinic) Dr. Liewluck has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sarepta Therapeutics. Dr. Liewluck has received publishing royalties from a publication relating to health care.