Lumbosacral plexopathy, complicating rhabdomyolysis in a 57-year-old man, presented with sudden weakness in both legs

Abstract

A 57-year-old man presented with weakness in both legs upon awakening after drinking. Magnetic resonance imaging (MRI) of the lumbar spine did not reveal any intraspinal abnormalities but MRI of the pelvis revealed lesions with abnormal intensities with heterogeneous contrast enhancement in both gluteal muscles. Serum creatine phosphokinase was markedly elevated. A diagnosis of lumbosacral plexopathy, complicating rhabdomyolysis was made. With supportive care he recovered well but mild weakness of the right ankle remained at 6 month-follow-up. Pelvic MRI is a helpful diagnostic tool in localizing rhabdomyolysis. Lumbosacral plexopathy should be included in the differential diagnosis of the such cases, presenting with sudden weakness of legs.

Keywords: Leg weakness; Lumbosacral plexopathy; Magentic resonance imaging; Rhabdomyolysis.

Fig. 1

Axial T2-weighted (A) and postcontrast T1-weighted (B) magnetic resonance imaging scans demonstrating hyperintense areas and rim enhancement around hypointense areas in both gluteal muscles, respectively.

Fig. 2

Technetium 99 m hydroxydiphosphonate whole body bone scan revealing increased soft tissue uptake in both hip areas on anterior (A) and posterior (B) views.