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Rehabilitation Practice and Science

Translated Title

重症多發性神經病變合併糖尿病神經病變導致四肢癱瘓：病例報告

Abstract

Objective: To describe a patient with the critical illness polyneuropathy superimposed on diabetic neuropathy and to highlight the importance of early rehabilitation after critical illness. Methods: A 42-year-old man with a previous history of diabetic polyneuropathy developed flaccid tetraplegia with respiratory failure after septic shock due to a liver abscess. This clinical manifestation, combined with the result of an electrodiagnostic study, suggested the acute exacerbation of polyneuropathy. Because a pre-existing polyneuropathy history complicated a differential diagnosis, we performed a comprehensive work-up to rule out other systemic diseases or metabolic disorders that may cause polyneuropathy. Finally, the diagnosis of critical illness polyneuropathy superimposed on diabetic neuropathy was established. Result: After 6 months of rehabilitation, the patient was able to ambulate with a walker under supervision and perform the activities of daily living with partial assistance. However, he still had muscle weakness, sensory impairment, autonomic dysfunction, and chronic disabilities. Conclusion: Critical illness polyneuropathy, resulting in limb weakness and difficulty in weaning from a ventilator, commonly occurs in critically ill patients and may cause severe disability. Early diagnosis and prevention of this condition are important to reduce the incidence and cost of hospital stays. Early rehabilitation can be a safe and feasible intervention and has the potential to improve clinical outcomes of critical illness.

Language

English

First Page

239

Last Page

246

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