Peroneal nerve palsy due to compartment syndrome after facial plastic surgery

Detalhes bibliográficos
Autor(a) principal: Godeiro-Júnior, Clécio de Oliveira [UNIFESP]
Data de Publicação: 2007
Outros Autores: Oliveira, Acary Souza Bulle [UNIFESP], Felício, André Carvalho [UNIFESP], Barros, Newton [UNIFESP], Gabbai, Alberto Alain [UNIFESP]
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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spelling 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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