Akmal M, Massry S G
Arch Intern Med. 1983 Apr;143(4):835-6.
Four patients with rhabdomyolysis due to drug intoxication were found to have peripheral nerve damage. Three patients were comatose and one was lethargic. The diagnosis of rhabdomyolysis was made by marked elevation in blood levels of creatine phosphokinase and strongly positive orthotoluidine test without RBCs in the urine. Acute renal failure developed in three patients and one had mild renal insufficiency. Electromyography showed damage to the brachial plexus in three of the patients and there was involvement of the musculocutaneous, radial, ulnar, and peroneal nerves in the fourth patient. The neurologic abnormalities disappeared completely within six weeks in two patients and considerably improved within four weeks in another patient after discharge from the hospital.
4例因药物中毒导致横纹肌溶解的患者被发现存在周围神经损伤。3例患者昏迷，1例嗜睡。横纹肌溶解的诊断依据为血肌酸磷酸激酶水平显著升高，且正甲苯胺试验强阳性，尿液中无红细胞。3例患者发生急性肾衰竭，1例有轻度肾功能不全。肌电图显示3例患者臂丛神经损伤，第4例患者的肌皮神经、桡神经、尺神经和腓总神经受累。2例患者的神经异常在6周内完全消失，另1例患者出院后4周内有明显改善。
