Greg D Kuhlman1, Kelly G Gwathmey1. 1. Department of Neurology, University of Virginia, P.O. Box 800394, Charlottesville, Virginia, 22908, USA.
Abstract
INTRODUCTION: We describe two patients who developed gluteal compartment syndrome (GCS) in the context of drug overdose. One patient developed a sciatic neuropathy, and one patient developed a lumbosacral plexopathy. METHODS: We reviewed the literature of atraumatic GCS and resultant neurological impairment. RESULTS: We reviewed 26 cases (our two cases and 24 previously published cases) of GCS and neurological impairment. All patients developed GCS in the context of drug or alcohol overdose. Creatine kinase was markedly elevated in all patients in which it was tested, and most patients developed renal failure. Seventeen patients had a fasciotomy, and 9 patients were managed conservatively. There appeared to be a trend toward worse prognosis in the conservatively managed group. DISCUSSION: Neurologists should be aware of GCS. Immediate recognition facilitates consideration of further diagnostic testing, including intracompartmental pressure measurement and consideration of surgical decompression, which may influence outcome. Muscle Nerve, 57: 325-330, 2018.
INTRODUCTION: We describe two patients who developed gluteal compartment syndrome (GCS) in the context of drug overdose. One patient developed a sciatic neuropathy, and one patient developed a lumbosacral plexopathy. METHODS: We reviewed the literature of atraumatic GCS and resultant neurological impairment. RESULTS: We reviewed 26 cases (our two cases and 24 previously published cases) of GCS and neurological impairment. All patients developed GCS in the context of drug or alcohol overdose. Creatine kinase was markedly elevated in all patients in which it was tested, and most patients developed renal failure. Seventeen patients had a fasciotomy, and 9 patients were managed conservatively. There appeared to be a trend toward worse prognosis in the conservatively managed group. DISCUSSION: Neurologists should be aware of GCS. Immediate recognition facilitates consideration of further diagnostic testing, including intracompartmental pressure measurement and consideration of surgical decompression, which may influence outcome. Muscle Nerve, 57: 325-330, 2018.