Going for a stroll on lurasidone: Considerations on an atypical case of acute compartment syndrome of both legs

Heliyon. 2023 Mar 31;9(4):e15047. doi: 10.1016/j.heliyon.2023.e15047. eCollection 2023 Apr.

Abstract

Non-traumatic acute bilateral compartment syndrome is a rare condition that may lead to limb ischemia. We describe a case of this syndrome occurring after a five-kilometer walk in a young woman receiving chronic treatment with lurasidone, leading to a bilateral foot-drop and rhabdomyolysis of the anterolateral compartment of both legs. Due to her late presentation in the emergency department, we opted for a conservative approach, closely monitoring her renal function. We noticed a subsequent clinical and biochemical improvement over the following days, with the patient returning to her daily routine in a matter of weeks, despite a persisting bilateral foot drop. Since atypical antipsychotics are known to be associated with rhabdomyolysis, while possibly exerting a toxic effect on mitochondria, we hypothesize that a mild aerobic physical exertion might have triggered the event, in the context of an iatrogenic muscle susceptibility to oxidative distress.

Keywords: Atypical antipsychotics; Foot-drop; Rhabdomyolysis; Walking.

Publication types

  • Case Reports