Bosco L, Russo T, Falzone Y M, Butera C, Del Prete A, Mellone R, Del Carro U, Filippi M, Previtali S C
Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Neuromuscular Repair Unit, INSPE and Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Heliyon. 2023 Mar 31;9(4):e15047. doi: 10.1016/j.heliyon.2023.e15047. eCollection 2023 Apr.
Non-traumatic acute bilateral compartment syndrome is a rare condition that may lead to limb ischemia. We describe a case of this syndrome occurring after a five-kilometer walk in a young woman receiving chronic treatment with lurasidone, leading to a bilateral foot-drop and rhabdomyolysis of the anterolateral compartment of both legs. Due to her late presentation in the emergency department, we opted for a conservative approach, closely monitoring her renal function. We noticed a subsequent clinical and biochemical improvement over the following days, with the patient returning to her daily routine in a matter of weeks, despite a persisting bilateral foot drop. Since atypical antipsychotics are known to be associated with rhabdomyolysis, while possibly exerting a toxic effect on mitochondria, we hypothesize that a mild aerobic physical exertion might have triggered the event, in the context of an iatrogenic muscle susceptibility to oxidative distress.
非创伤性急性双侧骨筋膜室综合征是一种罕见疾病，可能导致肢体缺血。我们描述了一例该综合征病例，发生在一名接受鲁拉西酮长期治疗的年轻女性进行5公里步行之后，导致双侧足下垂以及双腿前外侧骨筋膜室横纹肌溶解。由于她在急诊科就诊较晚，我们选择了保守治疗方法，密切监测她的肾功能。我们注意到在接下来的几天里临床和生化指标有所改善，尽管双侧足下垂持续存在，但患者在几周内就恢复了日常生活。由于已知非典型抗精神病药物与横纹肌溶解有关，同时可能对线粒体产生毒性作用，我们推测在医源性肌肉对氧化应激敏感的情况下，轻度有氧运动可能引发了这一事件。
