Muscle weakness in intensive care patients: Initial manifestation of vitamin D deficiency


A 72-year-old woman was referred to hospital for obnubilation with general muscle weakness and hypotonia. Biology showed hypocalcemia, hypophosphatemia, increased serum creatine kinase and alkaline phosphatase levels. Brain CT scan, cerebrospinal fluid examination, and electromyogram were normal. Clinical status and electroencephalogram were consistent with non-convulsive generalized status epilepticus. The treatment included clonazepam and CaCl2 and consciousness returned to normal. A treatment with multivitamin infusion containing vitamin D2 was given for 3 weeks. Muscle weakness improved partially. Serum vitamin D3 level was low and osteomalacic myopathy was diagnosed. A treatment was given with 25OH vitamin D3, 50 μg per day. Two months later, serum vitamin D3 and creatine kinase levels were normal and the patient could walk without help. We conclude that vitamin D status should be monitored in elderly patients with muscle symptoms and abnormal calcium status. Osteomalacic myopathy should be considered in critically ill patients with muscle symptoms of an unclear cause.

DOI: 10.1007/BF01705729


Citations per Year

195 Citations

Semantic Scholar estimates that this publication has 195 citations based on the available data.

See our FAQ for additional information.

Cite this paper

@article{Rimaniol1994MuscleWI, title={Muscle weakness in intensive care patients: Initial manifestation of vitamin D deficiency}, author={J. -M. Rimaniol and Florence Authier and Patrick Chariot}, journal={Intensive Care Medicine}, year={1994}, volume={20}, pages={591-592} }