PubMed · 9277686
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K Maeda. 1997. [Uremic encephalopathy, uremic coma].. https://pubmed.ncbi.nlm.nih.gov/9277686/
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States of severely impaired consciousness (SIC) are characterized by cognitive and motor limitations. This case report describes a 45-year-old female with impaired consciousness who began to 'walk'. She initially presented to the hospital unresponsive and was subsequently diagnosed with metabolic encephalopathy due to severe hypoglycaemia. Traditional indices of consciousness indicated a low level of responsiveness; however, during physical therapy, she displayed reciprocal walking movements when lifted to a standing position by two therapists. Despite her ability to walk increased distances during and after neurorehabilitation, she was unable to consistently demonstrate responses indicative of higher levels of consciousness. This case illustrates the challenge of rating patients with limited behavioural repertoire using established measures of impaired consciousness.
Neurologic complications in intensive care occur as the result of critical illness, intensive care therapies and procedures, or medical or surgical conditions; perioperatively; or because of underlying primary neurologic disease. These complications occur at greater frequency and are often unrecognized because critically ill patients are often intubated, sedated, and/or receiving neuromuscular blocking agents. Encephalopathy is the most common neurologic complication in the ICU and is usually multifactorial in origin. Sepsis is associated with the highest incidence of neurologic complications. Neurologic complications are associated with increased disability, longer hospital stay, and increased mortality. This review focuses on neurologic complications that are the result of critical illnesses and intensive care management.
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