title: A new syndrome sheds light on old medical & rehabilitative dilemmas: paraparesis due to rhabdomyolysis and bilaterally symmetric compartment syndrome in four patients. Cases study.
abstract: Via our description of a seemingly heterogeneous group of four patients who presented to our rehabilitation facility with a rather unusual clinical presentation of compartment syndrome with development of a flaccid paraparesis and rhabdomyolysis immediately after awakening from a prolonged sleep episode in an unusual posture - which might, in fact, be a 'new syndrome' - we have also come to address an important issue linking our group of patients - specifically, the complexities which present to a rehabilitative facility in the cases of unusual and unclear diagnoses. Eventually, all four of our patients remained severely disabled. All had suffered sensorimotor axonal demyelinative polyneuropathies and two patients had subclinical hypothyroidism. Prior to the prolonged sleep episode, they had all consumed alcohol and drugs. Using these four rather demanding diagnostic rehabilitative cases we address the ever-important issue of timely mutual communication and patience. For when a rehabilitative facility is confronted with patients whose diagnoses are not clear, the scope of the long-term comprehensive rehabilitation management faces some major obstacles with respect to how the rehabilitative team can succeed in designing a 'tailor-made' rehabilitation program for these patients, which often-times proves to be a rather tricky task requiring innovative and creative efforts on the parts of all those involved in the care of the patient. Quite a challenging task, indeed, yet one genuinely necessary to attempt to achieve so that the patient, family and, of course, the 'payer agency/provider' can all prepare themselves, realistically so as to obtain the best overall rehabilitative outcome for these patients. We conclude that what is most necessary for these unique patients is patience.
authors.affiliation: Reuth Medical Center, Section of Rehabilitation Medicine, POBox 9264, Tel Aviv, 61092 Israel.
authors.forename: Diana
authors.initials: D
authors.lastname: Goldin
authors.forename: Frida
authors.initials: F
authors.lastname: Shemesh
authors.forename: Rachel
authors.initials: R
authors.lastname: Eljashev-Shimshon
authors.forename: Avi
authors.initials: A
authors.lastname: Ohry
mesh_terms: D000328:Adult; D003161:Compartment Syndromes / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020335:Paraparesis / Q000209:etiology* / Q000628:therapy*; D012206:Rhabdomyolysis / Q000209:etiology* / Q000628:therapy*; D016896:Treatment Outcome