Multiple Compressive Neuropathy by Heterotopic Ossification After Organophosphate Intoxication - A Case Report -

J Korean Assoc EMG Electrodiagn Med 2010;12(2):132-136.
Published online October 1, 2010.

Abstract

Although heterotopic ossification (HO) frequently occurs in immobilized patients, nerve compression is rare. We report a case a 36-year-old man with sciatic and ulnar neuropathy by HO combined with organophosphate-induced delayed polyneuropathy (OPIDP) after hypoxic brain injury secondary to organophosphate intoxication. After 2 months from the onset, he complained of hypesthesia on right foot. Electrodianostic evaluation revealed right sciatic neuropathy and left ulnar neuropathy around elbow combined with OPIDP. CT and MRI of right hip showed HO at right obturator internus muscle with indentation of sciatic nerve and fatty atrophy changes in muscles innervated by sciatic nerve. Ultrasonography of left elbow showed ulnar nerve entrapment by HO. In this patient, multiple compression neuropathy by HO combined with polyneuropathy developed after relatively short period of immobilization. There has been no reports supporting the casual relationship between OP intoxication and HO.

Key Words: Heterotopic ossification, Compression neuropathy, Organophosphate-induced delayed polyneuropathy