Critical Illness Polyneurapathy

After removal of colon due to C-Diff, my sister now has CIP.  Conclusion in this article is positive.:Clinical Outcomes of Critical Illness Polyneuropathy, from Pharmacotherapy, Sandra L. Kane, Pharm.D., Joseph F. Dasta, M.S., FCCM, but I am particularly concerned about my sister's inability to speak.  I notice one doctor's answer to a wife's question about her CIP husband's inability to talk was that this inability is not secondary to CIP, and that tests should be done to rule out stroke.  My sister is on her (3 days March, +18 days April +3 days (so far) of May) 24th day of mechanical ventilation.  Can a patient have a stroke and it not be "shown" on a CAT scan?
Thank you.

[PaulMD]

Hi there.

I'm sorry to hear about your sister's condition at the present.  There can be several reasons why your sister cannot speak and critical illness polyneuropathy may not be able to explain that entirely.  I would agree with the possibility of a stroke, but not as dramatic as one sees.  These can be small strokes called "lacunar infarcts" which are small enough not to be detected on CT scan.  These small infarcts can be a consequence of critical illness as well but should improve once there is recovery from the illness and rehabilitation.  MRI can do a better job but with mechanical ventilation, it may not be practical or possible to do this.  I hope your sister can recover soon.

Regards and God bless.