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Neuromuscular Disorders in Severe Acute Respiratory Syndrome
Li-Kai Tsai, MD;
Sung-Tsang Hsieh, MD, PhD;
Chi-Chao Chao, MD;
Yee-Chun Chen, MD, PhD;
Yea-Huey Lin, MS;
Shan-Chwen Chang, MD, PhD;
Yang-Chyuan Chang, MD
Arch Neurol. 2004;61:1669-1673.
Objective To delineate and clarify neuromuscular disorders in patients with probable severe acute respiratory syndrome (SARS).
Design Case series with follow-up ranging from 3 weeks to 2 months.
Setting National Taiwan University Hospital, Taipei.
Patients We investigated 4 patients with SARS who had concomitant neuromuscular problems. A diagnosis of SARS was based on the demonstration of serum coronavirus antibodies. Clinical presentations, laboratory results, electrophysiologic findings, and follow-up conditions were determined.
Results Patients developed neuromuscular problems approximately 3 weeks after the onset of SARS. Two women experienced motor-predominant peripheral nerve disorders. A man developed myopathy and a third woman experienced neuropathy and myopathy. Cerebrospinal fluid obtained from 2 patients with neuropathy disclosed normal protein content and the absence of pleocytosis and SARS coronavirus antibodies. Both patients with myopathy had elevated serum creatine kinase levels. A rapid clinical and electrophysiologic improvement was evident during follow-up examinations, with a good prognosis.
Conclusions The neuromuscular problems in patients with SARS are considered to be critical-illness polyneuropathy or myopathy, possibly coexistent. Further pathological and microbiological studies are necessary to determine the relationship between SARS coronavirus and neuromuscular problems.
Author Affiliations: Departments of Neurology (Drs Tsai, Hsieh, Chao, and Y.-C. Chang and Ms Lin) and Internal Medicine (Drs Chen and S.-C. Chang), National Taiwan University Hospital and National Taiwan University College of Medicine, and Department of Anatomy and Cell Biology, National Taiwan University College of Medicine (Dr Hsieh), Taipei.
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