title: Self-inflicted tourniquet paralysis mimicking acute demyelinating polyneuropathy.
abstract: Tourniquet paralysis is an uncommon complication of surgery, and self-inflicted tourniquet paralysis has never been documented to our knowledge. We report a patient with bilateral self-induced tourniquet paralysis of the lower extremities, whose symptoms were initially attributed to an acute demyelinating sensorimotor polyneuropathy based on clinical presentation and electrodiagnostic study. After investigations failed to reveal a cause, he was found to have placed tourniquets on his legs because of a rare obsession with limb amputation known as apotemnophilia. Significant spontaneous partial resolution of clinical symptoms was noted after 6 weeks. Electrophysiologic evidence of segmental demyelination of multiple motor nerves localized to the same region may help to distinguish this condition from other forms of acute demyelinating polyneuropathy.
authors.affiliation: Department of Rehabilitation Medicine, University of Washington Medical Center, Seattle, Washington 98195, USA.
authors.forename: S
authors.initials: S
authors.lastname: Storm
authors.forename: M D
authors.initials: MD
authors.lastname: Weiss
mesh_terms: D000208:Acute Disease; D000328:Adult; D000671:Amputation, Surgical / Q000523:psychology; D003711:Demyelinating Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004568:Electrodiagnosis; D006801:Humans; D008297:Male; D009431:Neural Conduction; D009770:Obsessive Behavior / Q000150:complications / Q000523:psychology; D010243:Paralysis / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D016728:Self-Injurious Behavior / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D014111:Tourniquets / Q000009:adverse effects*