Focal Rhabdomyolysis and Brachial Plexopathy: An Association with Heroin and Chronic Ethanol Use

A 22-year-old man presented with acute swelling of the left neck and associated weakness of the left arm upon awakening after having snorted heroin. He had consumed large amounts of ethanol regularly for 7 years. Serum creatine kinase was greater than 19,000 units/l. A diagnosis of focal rhabdomyolysis and left brachial plexopathy was made. Focal rhabdomyolysis with associated plexopathy is an uncommon but recognized complication of acute heroin use. Chronic ethanol use may have a "sensitizing" role in the pathogenesis of this syndrome.