Nerve injuries following intramuscular injections: a clinical and neurophysiological study from Northwest India

Abstract

In developing countries, injections are frequently used to treat common ailments. Intramuscular injections (IMI) may damage peripheral nerves at the site of injection. Our objectives were to study the clinical features, neurophysiological findings, and outcome in patients with nerve injuries (NI) following IMI and to determine the factors affecting prognosis. We conducted a retrospective review of patients with NI following IMI, who were referred to our Neurophysiology Laboratory at Christian Medical College, Ludhiana, India, between January 1990 to December 2003. There were 36 (55%) patients with sciatic nerve palsy, 29 (44%) patients with radial nerve injury, and 1 (1%) patient with posterior femoral cutaneous nerve injury. In 57 (86%) patients, the IMI were given by uncertified medical practitioners. Needle electromyography (EMG) was analyzed in 36 patients (>or=60 days after onset). In 12 (33%) patients, there was EMG evidence of axonal damage with reinnervation, while in the other 24 (67%) patients, there was axonal damage without reinnervation. Only 18 (28%) patients had a good recovery. In conclusion, NI following IMI is a preventable iatrogenic hazard, which carries a poor prognosis.

Upper limb nerve injuries caused by intramuscular injection or routine venipuncture

“…Among them, 29 (9.4%) patients had a radial nerve injury. Pandian et al [17] identified 29 (43.9%) patients having suffered a radial nerve injury among the 66 intramuscular injection related nerve injury patients. Above two reports, radial nerve injury is the second most common lesion after sciatic nerve injury.…”

Sciatic nerve injection injury

“…25 It may show signs of acute denervation, presenting as a high insertional activity, positive spontaneous fibrillation, and sharp waves with low interference and recruitment in the affected muscles; alternatively it may show signs of chronic denervation with reinnervation, presenting with polyphasia, high amplitude, and a lowered interference pattern and recruitment in the affected muscles. 36,37 Compound muscle action potential amplitude, sensory nerve action potential amplitude and nerve conduction velocity can also be used in the diagnosis of SNII. 36 A motor nerve conduction study can be performed on the common peroneal and posterior tibial nerves, with electrodes placed on the extensor digitorum brevis and abductor hallucis longus muscles, respectively.…”

“…36,37 Compound muscle action potential amplitude, sensory nerve action potential amplitude and nerve conduction velocity can also be used in the diagnosis of SNII. 36 A motor nerve conduction study can be performed on the common peroneal and posterior tibial nerves, with electrodes placed on the extensor digitorum brevis and abductor hallucis longus muscles, respectively. A sensory nerve conduction study of the sural and superficial peroneal nerves can be performed, with averaging of the sensory nerve action potential.…”

Lokale bivirkninger ved parenteral administrasjon av legemidler

“…Prognosen for full tilheling etter nerveskader er generelt dårlig. I en rapport beregnet man at kun 28 % oppnådde full tilheling (11 …”