Acute anterior compartment syndrome associated with psychogenic polydipsia

Abstract

The aim of this paper is to describe the association of psychogenic polydipsia with anterior compartment syndrome. Case report. A 31-year-old man with glucose-6-phosphate-dehydrogenase (G6PD) deficiency had a history of paranoid schizophrenia from age 16 complicated by the use of drugs. Four years after the initial diagnosis of schizophrenia, he developed psychogenic polydipsia. This was complicated by episodic severe acute hyponatraemia with seizures and, on one occasion, by generalized rhabdomyolysis. One episode of severe acute hyponatraemia with delirium led to anterior compartment syndrome in both legs. Delayed diagnosis and treatment led to extensive myonecrosis and permanent bilateral foot drop. For 6 years his polydipsia remained partially controlled in a locked psychiatric ward with limited leave, until his sudden death related to severe water intoxication. Anterior compartment syndrome is a rare event associated with psychogenic polydipsia. Psychiatrists, physicians and surgeons should be aware of the seriousness of anterior compartment syndrome and its potential to increase morbidity in patients with psychogenic polydipsia.