과다 알코올 섭취 후 하지에 발생한 횡문근 융해와 다발성 말초 신경병증

Abstract

We report on a 44-year-old man with multiple peripheral neuropathies who developed bilateral lower extremity weakness. After heavy alcohol abuse, he experienced pain in both lower legs and severe erythematous swelling. The initial laboratory test suggested non-traumatic rhabdomyolysis caused by a heavy alcohol binge. Magnetic resonance images showed edema in the bilateral gluteus minimus and medius, pyriformis, and anterior calf muscles. The electrodiagnostic study showed bilateral sural, tibial, and peroneal neuropathies. In conclusion, in patients with acute and chronic alcohol abuse state, multiple neuropathies can be caused by integration of immobilization, electrolyte imbalance, compression, and direct myotoxicity. The patient began gait training with bilateral UD-flex orthosis with crutches. He was trained to use the crutches safely and an electrical stimulation test (EST) was applied. He was able to walk outdoors. We suggest consideration of early diagnosis and appropriate rehabilitative management to prevent severe secondary complications such as neuropathy.