Lumbosacral plexus injury and brachial plexus injury following prolonged compression.
We report the case of a 36-year-old woman who developed right upper and lower limb paralysis with sensory deficit after sedative drug overdose with prolonged immobilization. Due to the initial motor and sensory deficit pattern, brachial plexus injury or C8/T1 radiculopathy was suspected. Subsequent nerve conduction study/electromyography proved the lesion level to be brachial plexus. Painful swelling of the right buttock was suggestive of gluteal compartment syndrome. Elevation of serum creatine phosphokinase and urinary occult blood indicated rhabdomyolysis. The patient received medical treatment and rehabilitation; 2 years after the injury, her right upper and lower limb function had recovered nearly completely. As it is easy to develop complications such as muscle atrophy and joint contracture during the paralytic period of brachial plexopathy and lumbosacral plexopathy, early intervention with rehabilitation is necessary to ensure that the future limb function of the patient can be recovered. Our patient had suspected gluteal compartment syndrome that developed after prolonged compression, with the complication of concomitant lumbosacral plexus injury and brachial plexus injury, which is rarely reported in the literature. A satisfactory outcome was achieved with nonsurgical management.
Kao
Chung-Lan
CL
Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital,Taipei, Taiwan.
Yuan
Chia-Hei
CH
Cheng
Yuan-Yang
YY
Chan
Rai-Chi
RC
D000328:Adult; D001917:Brachial Plexus / Q000293:injuries*; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus / Q000293:injuries*; D009408:Nerve Compression Syndromes / Q000150:complications*