High CPK Levels after exercise, dizziness for over a week

[Cheryl2165]

My 17 year old son, who is in good physical shape and good health, worked out last Wednesday night.  Afterwards he felt dizzy......took a shower and went to bed. The next morning he was so dizzy he couldn't walk, was vomitting persistently, and was disoriented.  I took him to Urgent Care where he received fluids through an IV, as well as Phenergran.  The vomitting lasted 12 hours, however his dizziness has persisted for seven days now.  The Dr. said all his bloodwork came back ok, except that his CPK level was very high.  I'm worried about the long lasting dizziness.  I can't find any info on the internet, and I'm not sure what, if anything, I should do next.  Any suggestions?

[Philip D Parks, MD, MPH, MOccH, FACOEM]

Dear Cheryl,

There are a few (rare) conditions that can predispose individuals to rhabdomyolysis:

* polymyositis
* dermatomyositis
* or other hereditary muscle disease

Is there any chance that he has been using "nutritional supplements" or taking any medications/substances?

You are correct in that he (and you) are fortunate that his kidneys were not affected.

Do you know what your son's CPK level was?

~•~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

[Cheryl2165]

Hello Dr. Parks -
No apology necessary.  We followed up with my son's Dr. a few days later because, though his appetite returned and he was drinking, he still could not walk due to double vision/dizziness.  Rhabdomyolisis is the assumption.  After reading about this condition on the internet I feel fortunate that my son did not have kidney damage, since his symptoms seemed to indicate he had a pretty good "case" of it.  The dizziness has slowly subsided and he seems to be doing ok presently, and is leaving for a missions trip tomorrow morning.  I'm a bit nervous about that because during their free time, the kids will be white water rafting, rock climbing, etc.

I guess my only question now is this:  My son is 17, thin, and in fairly good condition.  It seems odd that he wouldn't have stopped exercising due to fatigue before he worked himself to the point of damaging his muscles so badly.  (He didn't have swollen muscles by the way).  Do you think there might be some underlying condition that needs to be further investigated, or do you think it was probably just a one time deal....he was not hydrated, nutritioned....etc. ??

Thanks so much!

[Philip D Parks, MD, MPH, MOccH, FACOEM]

Hi Cheryl,

I apologize for the delay in my response.

CPK = creatine phosphokinase and is an enzyme released from muscles under significant stress. A very vigorous workout + dehydration can cause a dramatic increase in CPK.

The dizziness likely reflects on-going dehydration.

Did the urgent care center perform any other laboratory tests in addition to CPK?

How is your son doing now?

~•~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.