Peroneal nerve palsy due to compartment syndrome after facial plastic surgery
Autor(a) principal: | |
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Data de Publicação: | 2007 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1590/S0004-282X2007000500018 http://repositorio.unifesp.br/handle/11600/3895 |
Resumo: | A 25-year-old white man, right after bilateral rhytidoplasty, presented with agitation, necessiting use of haloperidol. Some hours after, he developed severe pain in his legs and a diagnosis of neuroleptic malignant syndrome (NMS) was considered. Even with treatment for NMS he still complained of pain. A diagnosis of lower limb compartment syndrome (CS) was done only 12 hours after the initial event, being submitted to fasciotomy in both legs, disclosing very pale muscles, due to previous ischemia. This syndrome was not explained only by facial surgery, his position and duration of the procedure. It can be explained by a sequence of events. He had a history of pain in his legs during physical exercises, usually seen in chronic compartment syndrome. He used to take anabolizant and venlafaxine, not previously related, and the agitation could be related to serotoninergic syndrome caused by interaction between venlafaxine and haloperidol. Rhabdomyolisis could lead to oedema and ischmemia in both anterior leg compartment. This report highlights the importance of early diagnosis of compartment syndrome, otherwise, even after fasciotomy, a permanent disability secondary to peripheral nerve compression could occur. |
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Peroneal nerve palsy due to compartment syndrome after facial plastic surgeryParalisia de nervo fibular devido a síndrome compartimental após cirurgia plástica da facecompartment syndromeplastic surgeryrhytidoplastyperoneal nervesíndrome compartimentalcirurgia plásticaritidoplastianervo fibularA 25-year-old white man, right after bilateral rhytidoplasty, presented with agitation, necessiting use of haloperidol. Some hours after, he developed severe pain in his legs and a diagnosis of neuroleptic malignant syndrome (NMS) was considered. Even with treatment for NMS he still complained of pain. A diagnosis of lower limb compartment syndrome (CS) was done only 12 hours after the initial event, being submitted to fasciotomy in both legs, disclosing very pale muscles, due to previous ischemia. This syndrome was not explained only by facial surgery, his position and duration of the procedure. It can be explained by a sequence of events. He had a history of pain in his legs during physical exercises, usually seen in chronic compartment syndrome. He used to take anabolizant and venlafaxine, not previously related, and the agitation could be related to serotoninergic syndrome caused by interaction between venlafaxine and haloperidol. Rhabdomyolisis could lead to oedema and ischmemia in both anterior leg compartment. This report highlights the importance of early diagnosis of compartment syndrome, otherwise, even after fasciotomy, a permanent disability secondary to peripheral nerve compression could occur.Logo após ritidoplastia bilateral, um jovem de 25 anos apresentou agitação, necessitando uso de haloperidol. Algumas horas após, desenvolveu dor intensa em membros inferiores, e o diagnóstico de síndrome neuroléptica maligna foi considerado. Mesmo com o tratamento para tal, persistiu com dor. Após 12 horas do início do quadro, foi realizado o diagnóstico de síndrome compartimental de membros inferiores e o jovem foi submetido a fasciotomia bilateral. Uma seqüência de eventos desencadeou esta síndrome, já que sua ocorrência dificilmente seria justificada pela cirurgia facial e/ou posição do paciente durante o procedimento. O jovem apresentava previamente dor em membros inferiores aos exercícios, sugerindo a ocorrência de uma síndrome compartimental crônica. Ele fazia uso de anabolizantes e venlafaxina, não relatado no início do quadro, e a agitação poderia ser explicada por uma síndrome serotoninérgia desencadeada pela interação deste último medicamento e haloperidol. A rabdomiólise secundária a estes eventos causou edema e isquemia nos compartimentos anteriores de ambos os membros inferiores, levando a uma compressão secundária do nervo fibular. O caso em questão ilustra a importância do diagnóstico precoce da síndrome compartimental pois, caso contrário, mesmo com fasciotomia, uma complicação permanente devido à compressão de nervos periféricos pode se estabelecer.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Department of Neurology and NeurosurgeryUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Department of Vascular SurgeryUNIFESP, EPM, Department of Neurology and NeurosurgeryUNIFESP, EPM, Department of Vascular SurgerySciELOAcademia Brasileira de Neurologia - ABNEUROUniversidade Federal de São Paulo (UNIFESP)Godeiro-Júnior, Clécio de Oliveira [UNIFESP]Oliveira, Acary Souza Bulle [UNIFESP]Felício, André Carvalho [UNIFESP]Barros, Newton [UNIFESP]Gabbai, Alberto Alain [UNIFESP]2015-06-14T13:37:04Z2015-06-14T13:37:04Z2007-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion826-829application/pdfhttp://dx.doi.org/10.1590/S0004-282X2007000500018Arquivos de Neuro-Psiquiatria. Academia Brasileira de Neurologia - ABNEURO, v. 65, n. 3b, p. 826-829, 2007.10.1590/S0004-282X2007000500018S0004-282X2007000500018.pdf0004-282XS0004-282X2007000500018http://repositorio.unifesp.br/handle/11600/3895engArquivos de Neuro-Psiquiatriainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-04T18:10:21Zoai:repositorio.unifesp.br/:11600/3895Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-04T18:10:21Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Peroneal nerve palsy due to compartment syndrome after facial plastic surgery Paralisia de nervo fibular devido a síndrome compartimental após cirurgia plástica da face |
title |
Peroneal nerve palsy due to compartment syndrome after facial plastic surgery |
spellingShingle |
Peroneal nerve palsy due to compartment syndrome after facial plastic surgery Godeiro-Júnior, Clécio de Oliveira [UNIFESP] compartment syndrome plastic surgery rhytidoplasty peroneal nerve síndrome compartimental cirurgia plástica ritidoplastia nervo fibular |
title_short |
Peroneal nerve palsy due to compartment syndrome after facial plastic surgery |
title_full |
Peroneal nerve palsy due to compartment syndrome after facial plastic surgery |
title_fullStr |
Peroneal nerve palsy due to compartment syndrome after facial plastic surgery |
title_full_unstemmed |
Peroneal nerve palsy due to compartment syndrome after facial plastic surgery |
title_sort |
Peroneal nerve palsy due to compartment syndrome after facial plastic surgery |
author |
Godeiro-Júnior, Clécio de Oliveira [UNIFESP] |
author_facet |
Godeiro-Júnior, Clécio de Oliveira [UNIFESP] Oliveira, Acary Souza Bulle [UNIFESP] Felício, André Carvalho [UNIFESP] Barros, Newton [UNIFESP] Gabbai, Alberto Alain [UNIFESP] |
author_role |
author |
author2 |
Oliveira, Acary Souza Bulle [UNIFESP] Felício, André Carvalho [UNIFESP] Barros, Newton [UNIFESP] Gabbai, Alberto Alain [UNIFESP] |
author2_role |
author author author author |
dc.contributor.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Godeiro-Júnior, Clécio de Oliveira [UNIFESP] Oliveira, Acary Souza Bulle [UNIFESP] Felício, André Carvalho [UNIFESP] Barros, Newton [UNIFESP] Gabbai, Alberto Alain [UNIFESP] |
dc.subject.por.fl_str_mv |
compartment syndrome plastic surgery rhytidoplasty peroneal nerve síndrome compartimental cirurgia plástica ritidoplastia nervo fibular |
topic |
compartment syndrome plastic surgery rhytidoplasty peroneal nerve síndrome compartimental cirurgia plástica ritidoplastia nervo fibular |
description |
A 25-year-old white man, right after bilateral rhytidoplasty, presented with agitation, necessiting use of haloperidol. Some hours after, he developed severe pain in his legs and a diagnosis of neuroleptic malignant syndrome (NMS) was considered. Even with treatment for NMS he still complained of pain. A diagnosis of lower limb compartment syndrome (CS) was done only 12 hours after the initial event, being submitted to fasciotomy in both legs, disclosing very pale muscles, due to previous ischemia. This syndrome was not explained only by facial surgery, his position and duration of the procedure. It can be explained by a sequence of events. He had a history of pain in his legs during physical exercises, usually seen in chronic compartment syndrome. He used to take anabolizant and venlafaxine, not previously related, and the agitation could be related to serotoninergic syndrome caused by interaction between venlafaxine and haloperidol. Rhabdomyolisis could lead to oedema and ischmemia in both anterior leg compartment. This report highlights the importance of early diagnosis of compartment syndrome, otherwise, even after fasciotomy, a permanent disability secondary to peripheral nerve compression could occur. |
publishDate |
2007 |
dc.date.none.fl_str_mv |
2007-09-01 2015-06-14T13:37:04Z 2015-06-14T13:37:04Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/S0004-282X2007000500018 Arquivos de Neuro-Psiquiatria. Academia Brasileira de Neurologia - ABNEURO, v. 65, n. 3b, p. 826-829, 2007. 10.1590/S0004-282X2007000500018 S0004-282X2007000500018.pdf 0004-282X S0004-282X2007000500018 http://repositorio.unifesp.br/handle/11600/3895 |
url |
http://dx.doi.org/10.1590/S0004-282X2007000500018 http://repositorio.unifesp.br/handle/11600/3895 |
identifier_str_mv |
Arquivos de Neuro-Psiquiatria. Academia Brasileira de Neurologia - ABNEURO, v. 65, n. 3b, p. 826-829, 2007. 10.1590/S0004-282X2007000500018 S0004-282X2007000500018.pdf 0004-282X S0004-282X2007000500018 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Arquivos de Neuro-Psiquiatria |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
826-829 application/pdf |
dc.publisher.none.fl_str_mv |
Academia Brasileira de Neurologia - ABNEURO |
publisher.none.fl_str_mv |
Academia Brasileira de Neurologia - ABNEURO |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
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1814268368978444288 |