Citation Information :
Vas L, Suryavanshi V, Hemani JV. Reversal of Quadriplegia with Ultrasound-guided Dry Needling of Muscles Affected by Critical Illness Polyneuromyopathy/Neuropathy. 2022; 1 (2):50-54.
Case report: A 70-year-old developed critical illness polyneuropathy/critical illness polyneuromyopathy (CIP/CIPNM) quadriparesis with bilateral foot drop after a prolonged intensive care unit (ICU) stay. Systematic ultrasound-guided dry needling (USGDN) of axial and limb muscles reversed the low-grade co-contraction of agonist/antagonists of extremities surmised to cause CIP/CIPNM paresis to restore reciprocal inhibition essential for normal movements.
Disability of Arm, Shoulder, and Hand (DASH) score improved from 96 to 15, allowing daily activity resumption within 2 weeks and independent walking at 8 weeks with a walker for right foot drop. Sonography documented the reversal of structural disruption of muscle with USGDN.
Conclusion: CIP/CIPNM reversal with USGDN suggests low-grade co-contraction as a probable cause of paresis in this patient.
Hermans G, De Jonghe B, Bruyninckx F, et al. Interventions for preventing critical illness polyneuropathy and critical illness myopathy. Cochrane Database Syst Rev 2014;2014(1):CD006832. DOI: 10.1002/14651858.CD006832.pub3
Koch S, Wollersheim T, Bierbrauer J, et al. Long-term recovery in critical illness myopathy is complete, contrary to polyneuropathy. Muscle Nerve 2014;50(3):431–436. DOI: 10.1002/mus.24175
Vas LC. Ultrasound guided dry needling: relevance in chronic pain. J Postgrad Med 2022;68(1):1–9. DOI: 10.4103/jpgm.jpgm_710_21
Vulfsons S, Minerbi A. The case for comorbid myofascial pain—a qualitative review. Int J Environ Res Public Health 2020;17(14):5188. DOI: 10.3390/ijerph17145188
Lucas KR, Polus BI, Rich PA. Latent myofascial trigger points: their effects on muscle activation and movement efficiency. J Bodyw Mov Ther 2004;8(3):160–166. DOI: 10.1016/j.jbmt.2003.12.002
Dommerholt J, Bron C, Franssen J. Myofascial trigger points: an evidence informed review. J Man Manip Ther 2006;14(4):203–221. DOI: 10.1179/106698106790819991
Vas L, Khandagale N, Pai R. Successful management of chronic postsurgical pain following total knee replacement. Pain Med 2014;15(10):1781–1785. DOI: 10.1111/pme.12508
Vas L, Pai R. Ultrasound-guided dry needling as a treatment for post mastectomy pain syndrome—a case series of twenty patients. Indian J Palliat Care 2019;25(1):93–102. DOI: 10.4103/IJPC.IJPC_24_18
Vas LC, Pai R, Radhakrishnan M. Ultrasound appearance of forearm muscles in 18 patients with complex regional pain syndrome 1 of the upper extremity. Pain Pract 2013;13(1):76–88. DOI: 10.1111/j.1533-2500.2012.00539.x
Vas LC, Pai R, Pattnaik M. Musculoskeletal ultrasonography in CRPS: assessment of muscles before and after motor function recovery with dry needling as the sole treatment. Pain Physician 2016;19(1):E163–E179.
