Assessment of Recovery From Burn-Related Neuropathy by Electrodiagnostic Testing

Abstract

The purpose of this study was to investigate the recovery of burn related neuropathies by electrodiagnostic testing. Burn patients who presented to an American Burn Association verified burn center were interviewed and examined for clinical evidence of peripheral neuropathies by a physiatrist. Patients whom consented to participate were tested for electrodiagnostic evidence of peripheral neuropathy. Repeated studies were performed to assess for evidence of recovery.A total of 370 patients were screened. 36 (9.73%) patients had clinical evidence of neuropathy. Eighteen male patients with a mean total body surface area burn of 42% had nerve conduction studies performed. Etiologies of the injuries included 8 flame, 8 electrical and 3 others. Seventy three nerve conduction studies were performed and 58 of the tests were abnormal. The most commonly affected nerve was the median sensory (10). For patients with repeated tests, the mean time between tests was 169 days (SD 140 days). There was a significant difference between the initial and follow up test (McNemar's change test p=0.009). In subset analysis of motor and sensory abnormalities, there was no significant difference (p=0.07). The most common neuropathy identified in this cohort was the median sensory. Overall, there was improvement in the nerve conduction abnormalities examined. This study suggests that the prognosis for recovery after burn related neuropathy is good.

Insulin and exercise improved muscle function in rats with severe burns and hindlimb unloading

“…al reported a case of neurological injury after electrical burn (Schaefer et al, ). Less than 10% of burn patients could be found with clinical indications of motor and sensory abnormalities (Gabriel et al, ). However, genomic profile screening revealed possible damage to peripheral nerves following burn and HLU.…”

Burn injury and long-term nervous system morbidity: a population-based cohort study

“…Peripheral neuropathy in burn patients has been observed to be between 2% and 82%, 12 48 49 with mononeuropathies/mononeuritis being identified as the most common presentation. 14 Polyneuropathy has been described to be more common in full-thickness burns, where the TBSA>15% and when the initial length of stay is more than 20 days, suggesting polyneuropathy is predominantly a result of more severe injuries. 13 15 In this study, we found a marginal increase in admissions for mononeuropathies (other mononeuropathies).…”

“… 9 Electrodiagnostic studies using electromyography and motor nerve conduction velocities are more reflective of the physiology of the nerve and have shown features of polyneuropathy/mononeuropathy in 15–68% of patients after burn injury, 10–13 while clinical abnormalities have been reported in ∼10% of patients and related to the average burn surface area and aetiology of burn injury. 14 15 …”

Review of Burn Injury Research for the Year 2009

“…On follow-up, although there was no significant difference between motor and sensory nerve conductions, there was an improvement in nerve conduction. 68 This small study suggests that burn-related neuropathy may improve with time. Larger studies are needed to fully address this question.…”