ISSN: 1309 - 3843 E-ISSN: 1307 - 7384
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Tetraparezik Hastada Gelişen Kas Güçsüzlüğü: Kritik Hastalık Nöropatisi
Muscle Weakness in a Patient with Tetraparesis: Critical Illness Neuropathy
Received Date : 13 Mar 2018
Accepted Date : 18 Aug 2018
Available Online : 23 Nov 2018
Doi: 10.31609/jpmrs.2018-60456 - Makale Dili: TR
J PMR Sci. 2019;22(3):134-8
ÖZET
Kritik hastalık miyopatisi ve nöropatisi yoğun bakım hastalarında görülen nöromusküler zayıflığın en yaygın nedenlerindendir. Klinik belirtileri; azalmış kas germe refleksinden tetraplejiye ve uzamış mekanik ventilasyon ihtiyacına kadar değişkenlik gösterebilmektedir. Bu çalışmada, servikal fraktür sonrasında tek taraflı vertebral arter diseksiyonuna bağlı medulla oblongata ve serebellum infarktı olan ve tetrapleji gelişen, elektrofizyolojik yöntemler ile klinik hastalık nöropatisi saptanan bir olgunun sunulması amaçlanmıştır. Yoğun bakım hastalarında primer sorunu ne olursa olsun; kas güçsüzlüğü, hiporefleksi, mekanik ventilatörden ayrılamama gibi belirtiler varsa klinik hastalık nöropatisi akla gelmeli ve en iyi sonucu alabilmek için tedaviye en kısa sürede başlanmalıdır.
ABSTRACT
Critical illness myopathy and neuropathy are the most common causes of neuromuscular weakness in intensive care patients. Clinically; decreased muscle stretching reflex, increased tetraplegia and increased need for mechanical ventilation. Here, we present a case of cerebellar infarction with medulla oblongata and cerebellum infarction due to unilateral vertebral artery dissection after cervical fracture, and tetraplegia and electrophysiologic methods with critical illness neuropathy. Critical illness neuropathy should be considered if there are indications such as muscle weakness, hyporeflexia, inability to wean from mechanical ventilation in intensive care unit patients regardless of the primary problem and the treatment should be started as soon as possible to get the best results.
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