CRITICAL ILLNESS POLYNEUROPATHY IN A FEMALE ADMITTED IN TERTIARY CARE CENTRE: A CASE REPORT

Critical Illness Polyneuropathy (CIP) is a neuromuscular disorder affecting critically ill patients, often complicating the management of conditions like sepsis, multiple organ dysfunction syndrome (MODS), and prolonged mechanical ventilation. This case report presents a 55-year-old female admitted with septic shock secondary to a urinary tract infection, who developed CIP during her ICU stay. The patient's clinical course was marked by multiple organ dysfunction, requiring prolonged mechanical ventilation and hemodialysis. Despite improving respiratory function, difficulty in weaning from the ventilator and developing symmetrical limb weakness prompted further investigation. Neurological examination revealed marked muscle weakness (1/5 distal, 2/5 proximal) in all four limbs, with decreased reflexes. Nerve conduction studies indicated axonal polyneuropathy, consistent with CIP. Management focused on treating the underlying sepsis, ensuring strict glycemic control, and implementing early physiotherapy to prevent further muscle atrophy. Gradual improvement in limb strength was observed, allowing successful weaning from mechanical ventilation by the end of the ICU stay. Proximal muscle strength improved to 3/5, and distal strength to 2/5 at discharge, though sensory deficits persisted. A comprehensive rehabilitation plan, including outpatient physiotherapy and occupational therapy, was established. The patient and her family were educated on the importance of continued therapy to facilitate recovery. This case emphasizes the importance of early diagnosis and intervention in CIP, especially in patients with prolonged ICU stays and sepsis, as timely management can improve outcomes, though recovery may be slow and incomplete. Further research is needed to better understand CIP and develop targeted therapies.