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Small‐nerve‐fiber pathology in critical illness documented by serial skin biopsies
Author(s) -
Skorna Miroslav,
Kopacik Roman,
Vlckova Eva,
Adamova Blanka,
Kostalova Milena,
Bednarik Josef
Publication year - 2015
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.24489
Subject(s) - medicine , pathology , nerve fiber , skin biopsy , biopsy , anatomy
: Small‐fiber pathology can develop in the acute phase of critical illness and may explain chronic sensory impairment and pain in critical care survivors. Methods : Eleven adult ischemic stroke patients in a neurocritical care unit were enrolled in an observational cohort study. Intraepidermal nerve fiber density (IENFD) in the distal leg was assessed on admission to the intensive care unit and 10–14 days later, together with electrophysiological testing. Results : Of the 11 patients recruited, 9 (82%) had sepsis or multiple‐organ failure. Median IENFD on admission (5.05 fibers/mm) decreased significantly to 2.18 fibers/mm ( P < 0.001), and abnormal IENFD was found in 6 patients (54.5%). Electrodiagnostic signs of large‐fiber neuropathy and/or myopathy were found in 6 patients (54.5%), and autonomic dysfunction was found in 2 patients (18.2%). Conclusion : Serial IENFD measurements confirmed the development of small‐fiber sensory involvement in the acute phase of critical illness. Muscle Nerve 52 : 28–33, 2015