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Two articles [1,2] in this issue discuss acute myopathy that can develop in the setting of critical illness. Patients usually develop acute myopathy when two of the following three conditions exist: 1) the patient is treated with a non-depolarizing neuromuscular blocking agent; 2) glucocorticoids are used; or 3) the patient has a febrile illness or sepsis. The articles indicate we do not know how to predict which patients will develop acute myopathy and that acute myopathy may resemble axonal neuropathy on EMG testing. Some patients with acute illness myopathy manifest myonecrosis with elevated serum CK concentration, while others do not have an appreciable increase in CK. It is likely that in …
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