Gluteal Compartment Syndrome Complicated with Bilateral Sciatic Neuropathy.

A 27 year-old man was admitted for bilateral legs weakness and rhabdomyolysis after a prolonged sitting posture for 10 hours due to an overuse of drugs for schizophrenia. Neurological examination showed feet drop, absent ankle tendon reflexes and hypesthesia to pin-prick stimulation below knees. The straight-leg-raising test was normal. A lumbar spine MRI study did not show abnormal spinal lesion but found diffuse hyperintense change of lower back muscles with predominance on the left side. Serum creatine phosphokinase (CPK) level was 31478 IU/L (normal 39-308 IU/L). The nerve conduction velocity study showed absent responses of bilateral peroneal, tibial and sural nerves and electromyographic study showed active denervation at sampling muscles below the Hamstrings, while sparing the tensor fascia lata. A follow-up pelvic MRI study disclosed necrosis of bilateral gluteal muscles with marginal contrast enhancement (Figure). Bilateral gluteal compartment syndrome (GCS) with