Compartment syndrome: Neuromuscular complications and electrodiagnosis

Compartment syndrome (CS) is a treatable condition characterized by elevated intracompartmental pressure and may be acute or chronic in nature. Sustained elevated compartment pressure can lead to ischemia and necrosis of muscle as well as injury to peripheral nerves, creating a deficit that may be neuropathic, myopathic, or mixed. While electrodiagnostic assessments are of limited utility in the diagnosis of acute/traumatic CS, they can assist with prognosticating return of function after surgical fasciotomy or in clarifying the injury pattern in cases in which a traumatic injury results in subsequent neuromuscular deficits. They can also be used to rule out conditions that mimic chronic exertional CS. During electrodiagnostic assessment, clinicians should be aware of patterns associated with muscle fibrosis vs denervation and use this information to assist with prognostication and appropriate counseling for patients regarding any interventional or adaptive treatments that may help restore function.