Key messages

• As with neuropathy and clinical assessment may be misleading.

• Neurological consultation, magnetic resonance imaging of the cervical spinal cord, electrophysiological testing, and, in particular, measurements of creatine phosphokinase and muscle biopsy usually establish the diagnosis.

• Neuromuscular blocking agents and steroids, together with sepsis, may be important causes of the myopathy in critical illness.

• The results of investigations are important, largely for prognostic reasons.

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