Jeon Hong-Jun, Cho Byung-Moon, Oh Sae-Moon, Park Se-Hyuck
Department of Neurosurgery, Kangdong Sacred Heart Hospital, Hallym University, College of Medicine, Seoul, Korea.
J Korean Neurosurg Soc. 2007 Dec;42(6):481-3. doi: 10.3340/jkns.2007.42.6.481. Epub 2007 Dec 20.
A 57-year-old man presented with weakness in both legs upon awakening after drinking. Magnetic resonance imaging (MRI) of the lumbar spine did not reveal any intraspinal abnormalities but MRI of the pelvis revealed lesions with abnormal intensities with heterogeneous contrast enhancement in both gluteal muscles. Serum creatine phosphokinase was markedly elevated. A diagnosis of lumbosacral plexopathy, complicating rhabdomyolysis was made. With supportive care he recovered well but mild weakness of the right ankle remained at 6 month-follow-up. Pelvic MRI is a helpful diagnostic tool in localizing rhabdomyolysis. Lumbosacral plexopathy should be included in the differential diagnosis of the such cases, presenting with sudden weakness of legs.
一名57岁男性在饮酒后醒来出现双下肢无力。腰椎磁共振成像(MRI)未发现椎管内异常,但骨盆MRI显示双侧臀肌有病变,呈异常信号强度,增强扫描有不均匀强化。血清肌酸磷酸激酶显著升高。诊断为腰骶丛神经病合并横纹肌溶解症。经过支持治疗,他恢复良好,但在6个月随访时右踝仍有轻度无力。骨盆MRI是定位横纹肌溶解症的有用诊断工具。对于此类突然出现腿部无力的病例,腰骶丛神经病应列入鉴别诊断。