Rhabdomyolysis and Peripheral Neuropathy Without Compartment Syndrome, Induced by Antipsychotic Drug Intoxication: A Case Report

Abstract

Rhabdomyolysis is a complex medical condition in which insufficient energy supply to muscles results in the destruction of skeletal muscle and leakage of toxic intracellular substances into the systemic circulation. The common cause of rhabdomyolysis is a direct traumatic injury; however, it can also occur due to non-traumatic factors, including infection, toxins, and drugs. Rhabdomyolysis as an adverse effect of antipsychotic medication is not well understood. Peripheral neuropathy is a rare complication of rhabdomyolysis. Here, we present a case of a 22-year-old woman who presented to the emergency department with right thigh pain following an antipsychotic drug overdose and 3 days of loss of consciousness. There was no history of trauma to her leg. Physical examination, diagnostic testing, and imaging indicated a diagnosis of rhabdomyolysis and peripheral neuropathy. The patient underwent an incision with drainage, a muscle biopsy, and was treated with hydration, after which her condition improved, and she was discharged. Follow-up testing indicated lasting nerve injury. Peripheral neuropathy can occur even in patients with rhabdomyolysis without compartment syndrome. Awareness of this rare complication may help in initiating early interventions to minimize irreversible sequelae.