Bilateral thigh compartment syndromes from extended sitting with forward bending

Area of Science:

• Neurology
• Orthopedic Surgery
• Sports Medicine

Background:

• Alcohol consumption and sleeping in unusual positions are known risk factors for compression neuropathies.
• Previous cases of atraumatic compartment syndrome (TCS) with nerve palsy exist, but the exact cause remains unclear due to limited medical history.

Observation:

• A unique case of bilateral leg palsy occurred in an individual after sleeping in a prolonged forward-bending position.
• The unusual sleeping posture was documented via photography, providing key visual evidence.

Findings:

• The prolonged compression of femoral arteries likely led to bilateral thigh compartment syndromes (TCS).
• Muscle MRI and needle electromyography (EMG) findings supported the hypothesis of sciatic nerve damage secondary to TCS.
• This case provides strong evidence linking prolonged unusual sleeping positions to atraumatic compartment syndrome and subsequent sciatic nerve palsy.

Implications:

• This case underscores the potential for severe neurological complications arising from seemingly innocuous behaviors.
• Highlights the importance of considering positional causes in atraumatic compartment syndrome and nerve palsy.
• Suggests awareness regarding sleeping positions, particularly after alcohol consumption, to prevent such injuries.