Bilateral Sciatic Neuropathy Due to Drug Overdose with Coma

藥物過量昏迷後之雙側坐骨神經病變

范怡姍(Susan Y Fan) ； 洪章仁(Chang-Zern Hong) ； 謝霖芬(Lin-Fen Hsieh) ； 邵以鈞(Yii-Jiun Shao) ； 陳旭漪(Hsu-Yi Chen)

《台灣復健醫學雜誌》 34卷1期 (2006/03) Pp. 33-39

https://doi.org/10.6315/2006.34(1)05

摘要

意識不清所造成的周邊神經損傷並不罕見，但因昏迷而導致雙側坐骨神經病變則十分罕見。
本文報告一位因藥物過量而導致昏迷，並引起雙側坐骨神經病變之案例。個案是一位三十七歲女性，因憂鬱症和長期失眠經常服用安眠藥及抗憂鬱藥劑。某日患者服用過量藥劑後神智變差，且以雙膝伸直的姿勢昏睡了將近十幾個小時。她醒來後發現自己無法移動雙腳而跌倒在地上。送醫後發現個案有雙側臀部及大腿腫賬及肌蛋白尿(myoglobulinuria)。電學檢查發現雙側坐骨神經有完全去神經現象(complete denervation)。經過十九個月的復健治療後，電學檢查追蹤可見部份神經再生(reinnervation)。雖然個案在神經學方面有後遺症但是功能上有明顯的進步。如此可見，周邊神經損傷可能造成嚴重的功能喪失，但是復健治療有助於此類病患康復。

關鍵字

坐骨神經病變 ； 昏迷 ； 復健

並列摘要

Limb compression in an unattended comatous patient often results in peripheral nerve injuries; however, bilateral sciatic neuropathy in these patients has rarely been described in literature. A 37-year-old woman with bilateral numbness and paralysis of the lower limb after drug overdose with coma was reported. After onset of unconsciousness, she was in a seated position with trunk and hips flexed and knees nearly fully extended for approximately ten hours. In the department of emergency, she was found to have bilateral thighs and buttocks swollen as well as myoglobulinuria. Electrodiagnostic studies supported a diagnosis of complete denervation bilaterally in the distribution of the sciatic nerve. After 19 months of intense rehabilitation, some evidence of reinnervation was noticed in follow-up electrodiagnostic testing. There were significant improvements in motor function with some remaining neurological deficits. According to our findings, severe and disabling sequelae may result from such peripheral nerve injuries, however, rehabilitation for these patients is helpful.

並列關鍵字

sciatic neuropathy ； coma ； rehabilitation