[Drug-induced rhabdomyolysis and lesions of peripheral nerves. Sequelae of local ischemia within the scope of circulatory collapse?].

We report on two patients with severe rhabdomyolysis and peripheral nerve involvement after drug intoxication. Nerve conduction studies of the paretic extremities of both patients could be performed within 12 h of the onset. Several nerves revealed evidence of conduction blocks in the paretic extremities. One of the patients who had taken heroin died and postmortem examination was performed. A drug-induced immune vasculitis could not be demonstrated. Besides striated muscle necrosis, extensive myocardial fragmentation was shown. Territorial ischemia, resulting from systemic hypotension and mechanical compression of arteries, seems to have been the cause of the myonecroses and peripheral nerve damage in the unconscious patients.