Critical care of neuromuscular disorders

In this episode of Critical Matters, Dr. Sergio Zanotti interviews Dr. Kamran Athar about the management of acute neuromuscular disorders in the ICU, focusing on Guillain-Barre Syndrome and Myasthenia Gravis. Dr. Athar provides a broad differential diagnosis for acute neuromuscular weakness, detailing conditions affecting the spinal cord, nerve roots, peripheral nerves, neuromuscular junction, and muscles. The discussion covers the epidemiology, pathophysiology, clinical presentation, and diagnosis of Guillain-Barre Syndrome, including various subtypes and triggers. They delve into treatment strategies, such as IVIG and plasma exchange, and address the management of respiratory failure and autonomic dysfunction. The conversation shifts to Myasthenia Gravis, discussing its pathophysiology, diagnosis, and the importance of recognizing myasthenic crises. They explore treatment options, including immunomodulating therapies and the role of thymectomy, while also highlighting medications to avoid in myasthenic patients. The episode concludes with personal reflections on the practice of medicine and the power of forgiveness.