Electromyographic and histological features of postpartum hypernatremic rhabdomyolysis
A 25-year-old lady was admitted 3 weeks after fourth delivery with 5 days progressive quadriparesis and disorientation with drowsiness for 3 days. She was bedbound and incontinent for 2 days and had symmetric proximally dominant quadriparesis and during recovery was found to have ataxia. Serum CK was 58,587 units/l at admission and reduced to 917 units/l on 15 days from the onset of symptoms when needle EMG was performed. EMG revealed moderate amount of fibrillation and positive sharp waves, which was prominent in proximal muscles. Myotonic discharges were seen in biceps brachii, quadriceps and tibialis anterior []. Left biceps brachii muscle revealed features of extensive rhabdomyolysis, a few regenerating fibers and areas of perivascular infiltration as shown in . Clinical evaluation was normal at 1 month follow-up and serum CK level was 90 units/l.