Neurological Research and Practice volume 5 , Article number: 66 Cite this article. Metrics details. In sepsis-associated critical illness neuromyopathy CIPNM serial electrical stimulation of motor nerves induces a short-lived temporary recovery of compound muscle action potentials CMAPs termed facilitation phenomenon FP. This technique is different from other stimulation techniques published.
From our previous study cohort of 18 intensive care unit patients with sepsis associated CIPNM showing profound muscle weakness and low or missing CMAPs on nerve conduction studies, six patients with different severity could be followed.
In a pilot sub-study we analyzed the variability of FP during follow up. Over up to 6 weeks we performed 2—6 nerve conduction studies with our novel stimulation paradigm.
Motor nerves were stimulated at 0. Needle electromyography was checked once for spontaneous activity to discover potential denervation and muscle fiber degeneration.
Serum electrolytes were checked before any examination and corrected if abnormal. In all six patients a striking variability in the magnitude and pattern of FP could be observed at each examination in the same and in different motor nerves over time. With the first stimulus most CMAPs were below 0. With slow serial pulses CMAPs could gradually recover with normal shape and near normal amplitudes. With improvement of muscle weakness subsequent tests revealed larger first CMAP amplitudes and smaller magnitudes of FP.
