Abstract
We describe the case of a 75-year-old woman who was admitted to our ICU because of status asthmaticus and required mechanical ventilation. She was treated with high-dose corticosteroids and deep sedation without neuromuscular blocking agents, and overcame the crisis. She remained comatose for several days even after discontinuation of sedatives, and thereafter her serum creatine kinase level increased to 9,150 U/l. As she regained consciousness, flaccid motor paralysis of all extremities became evident. Electrophysiological studies indicated acute myopathy. A muscle biopsy specimen demonstrated selective loss of myosin myofilaments, thus the diagnosis of acute quadriplegic myopathy was made. Not only high-dose corticosteroid therapy, but also immobilization due to sedatives and prolonged comatose state was considered to contribute to the development of this acute quadriplegia.
