Ann Clin Neurophysiol.  2020 Apr;22(1):19-23. 10.14253/acn.2020.22.1.19.

Immobilization-induced rhabdomyolysispatients with peripheral neuropathy:clinical, laboratory and imagingfindings

• Seok JI
• Lee IH
• Ahn KS
• Kang GW
• Lee JW
• Kwak S

• KMID: 2500299
• DOI: http://doi.org/10.14253/acn.2020.22.1.19

Abstract

Background
Peripheral nerve injury rarely occurs in patients with rhabdomyolysis. Based on our experience and previous reports, we consider prolonged immobilization a risk factor for the development of peripheral neuropathy in rhabdomyolysis patients.
Methods
This study analyzed 28 patients with rhabdomyolysis due to prolonged immobilization. We analyzed their demographic and laboratory data, clinical and imaging findings, and outcomes, and compared these factors between patients with and without neuropathy.
Results
Seven of the 28 patients had peripheral neuropathy, including sciatic neuropathy or lumbosacral plexopathy. Compared to those without neuropathy, the patients with neuropathy were younger (p = 0.02), had higher peak creatine kinase (CK) levels (p = 0.02), had higher muscle uptake in bone scans (p = 0.03), and more frequently exhibited abnormal muscle findings in computed tomography (CT) (p = 0.004).
Conclusions
Patients with prolonged immobilization-induced rhabdomyolysis and neuropathy had higher CK levels, increased uptake on bone scans, and more-frequent abnormal muscles on CT than those without neuropathy. These findings indicate that peripheral neuropathy is more likely to develop in patients with severe muscle injury.

Keyword

Immobilization; Peripheral nervous system diseases; Rhabdomyolysis

Figure

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  Fig. 1. Examples of abnormal computed tomography findings. (A) Axial image showing a low muscle signal intensity and swelling of the right gluteus medius muscle (arrow). (B) Axial image showing diffuse swelling of the right gluteous medius muscle (arrow). GM, gluteus maximus; gm, gluteus medius.

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  Fig. 2. Causes of prolonged immobilization in the two study groups.

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