Abstract
There have been reports on patients with symptoms of crush syndrome and peripheral nerve paralysis caused by limb compression on prolonged immobilization, after administration of a psychotropic drug. However this rare case involved pulmonary embolism in addition to the clinical condition mentioned above. A 73-year-old man was receiving outpatient treatment for manic depression. A change in his medication resulted in heavy sedation, and he fell asleep for approximately 10 h in the cross-legged position. On waking, he was paralyzed in the right leg. After arrival at our hospital, a physical examination was performed, which indicated a swelling and tenderness from the right hip to the thigh, as well as sciatic nerve palsy. During the examination, the patient developed respiratory distress. Computed tomography revealed a swelling in the muscles from the right gluteus medius to the quadriceps and pulmonary embolism. Blood test results showed elevated levels of creatine phosphokinase. The patient was diagnosed with the crush syndrome and pulmonary embolism. The possibility of complication with pulmonary embolism merits careful attention in patients who present with disturbance of consciousness following drug administration, especially in those with crush syndrome caused by prolonged compression of the legs.
