Chapter 117. Critical Illness Myopathy

  1. Robert P. Lisak MD, FAAN, FRCP Parker Webber Chair Professor Chair Neurologist-in-Chief Chief2,3,
  2. Daniel D. Truong MD, FAAN Head4,
  3. William M. Carroll MBBS, MD, FRACP, FRCP(E) Head5 and
  4. Roongroj Bhidayasiri MD, FRCP Director6,7
  1. Muhammad Al-Lozi MD Professor of Neurology and
  2. Alan Pestronk MD Professor of Neurology

Published Online: 18 MAY 2010

DOI: 10.1002/9781444317008.ch117

International Neurology: A Clinical Approach

International Neurology: A Clinical Approach

How to Cite

Al-Lozi, M. and Pestronk, A. (2009) Critical Illness Myopathy, in International Neurology: A Clinical Approach (eds R. P. Lisak, D. D. Truong, W. M. Carroll and R. Bhidayasiri), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444317008.ch117

Editor Information

  1. 2

    Wayne State University School of Medicine, Detroit, MI, USA

  2. 3

    Detroit Medical Center, Harper University Hospital, Detroit, MI, USA

  3. 4

    The Parkinson and Movement Disorder Institute, Memorial Neuroscience Institute, Orange Coast Memorial Medical Center, Fountain Valley, CA, USA

  4. 5

    Sir Charles Gairdner Hospital, Nedlands, Perth, Australia

  5. 6

    Chulalongkorn Comprehensive Movement Disorders Center, Chulalongkorn University Hospital, Bangkok, Thailand

  6. 7

    University of California at Los Angeles, School of Medicine, Los Angeles, CA, USA

Author Information

  1. Department of Neurology, Washington University in Saint Louis, St Louis, MO, USA

Publication History

  1. Published Online: 18 MAY 2010
  2. Published Print: 11 SEP 2009

ISBN Information

Print ISBN: 9781405157384

Online ISBN: 9781444317008



  • critical illness myopathy (CIM), weakness with inexcitable membranes and loss of myosin and thick filaments in muscle fibers;
  • CIM, developing in patients - in intensive care unit with acute medical illnesses, as asthma, chronic obstructive pulmonary disease, sepsis;
  • CIM incidence in patients - depending on definition of syndrome;
  • serum creatine kinase (CK) level, high in patients during first 2 weeks;
  • muscle biopsy, confirming diagnosis - in ruling out potentially treatable causes of weakness;
  • major pathophysiological changes in CIM - selective loss of major contractile protein (myosin) and inexcitability of muscle membrane;
  • CIM, differentiated from central nervous system and neuromuscular disorders


This chapter contains sections titled:

  • Introduction

  • Epidemiology

  • Clinical features

  • Investigations

  • Pathology

  • Pathophysiology

  • Differential diagnosis

  • Treatment

  • Further reading