Neuromuscular disorders in severe acute respiratory syndrome

Arch Neurol. 2004 Nov;61(11):1669-73. doi: 10.1001/archneur.61.11.1669.


Objective: To delineate and clarify neuromuscular disorders in patients with probable severe acute respiratory syndrome (SARS).

Design: Case series with follow-up ranging from 3 weeks to 2 months.

Setting: National Taiwan University Hospital, Taipei.

Patients: We investigated 4 patients with SARS who had concomitant neuromuscular problems. A diagnosis of SARS was based on the demonstration of serum coronavirus antibodies. Clinical presentations, laboratory results, electrophysiologic findings, and follow-up conditions were determined.

Results: Patients developed neuromuscular problems approximately 3 weeks after the onset of SARS. Two women experienced motor-predominant peripheral nerve disorders. A man developed myopathy and a third woman experienced neuropathy and myopathy. Cerebrospinal fluid obtained from 2 patients with neuropathy disclosed normal protein content and the absence of pleocytosis and SARS coronavirus antibodies. Both patients with myopathy had elevated serum creatine kinase levels. A rapid clinical and electrophysiologic improvement was evident during follow-up examinations, with a good prognosis.

Conclusions: The neuromuscular problems in patients with SARS are considered to be critical-illness polyneuropathy or myopathy, possibly coexistent. Further pathological and microbiological studies are necessary to determine the relationship between SARS coronavirus and neuromuscular problems.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cerebrospinal Fluid / chemistry
  • Electrophysiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuromuscular Diseases / etiology*
  • Neuromuscular Diseases / pathology*
  • Severe Acute Respiratory Syndrome / complications*