Diagnostic Criteria of Stevens et al for Critical Illness Myopathy (CIM)

Description

Stevens et al listed criteria for the diagnosis of Critical Illness Myopathy (CIM) in a patient with intensive care unit-acquired weakness. The authors are from the Johns Hopkins University, Uniformed Services University of Health Sciences, Ohio State University, Centre Hospitalier de Poissy-Saint-Germain and University of Versailles Saint-Quentin en Yvelines Garches.

The criteria are modified from those of Lacomis et al.

Diagnostic criteria for CIM:

(1) The patient meets the criteria for ICUAW (see previous section).

(2) Sensory nerve action potential (SNAP) amplitudes are greater than 80% of the lower limit of normal (LLN) in 2 or more nerves.

(3) Needle electromyogram shows short duration, low amplitude motor unit potentials with early or normal full recruitment in >= 2 muscle groups.

(4) Direct muscle stimulation shows reduced excitability in >= 2 muscle groups.

(5) A muscle biopsy shows hisotlogic changes consistent with myopathy.

where:

• The needle electromyograms may (or may not) show fibrillation potentials.

Findings	Interpretation
1 and 5	probable CIM
1 and 2 and (3 or 4)	probable CIM
1 and 2 and (3 or 4) and 5	definite CIM

Differential diagnosis:

(1) cachexia

(2) rhabdomyolysis

(3) disuse muscle atrophy

(4) decompensation of a primary muscle disorder

(5) steroid myopathy

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Description

Specialty

ICD-10