Pathogenesis and recovery of tetraplegia after electrical injury.
The site of neurological damage causing paralysis after electrical trauma remains to be clarified. A patient is described who developed a flaccid tetraplegia after a high voltage electrical injury. The findings on initial examination and neurophysiological investigation showed a very severe generalised sensory-motor polyneuropathy. His subsequent follow up over 60 months showed a remarkable degree of reinnervation and the unmasking of a myelopathy. The degree of reinnervation noted suggests an axonopathy that left the other elements of the peripheral nerves relatively spared. These findings provide the most convincing evidence to date that a generalised polyneuropathy can follow electrical injury and that it results from non-thermal mechanisms such as electroporation.
Thaventhiran
J
J
Department of Neurology, Homerton Hospital, Homerton Row, London E9 6SR, UK.
O'Leary
M J
MJ
Coakley
J H
JH
Rose
M
M
Nagendran
K
K
Greenwood
R
R
D000328:Adult; D001369:Axons / Q000502:physiology; D004556:Electric Injuries / Q000175:diagnosis / Q000503:physiopathology*; D004576:Electromyography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000294:innervation; D009416:Nerve Regeneration / Q000502:physiology*; D009460:Neurologic Examination; D011115:Polyneuropathies / Q000175:diagnosis / Q000503:physiopathology; D011782:Quadriplegia / Q000175:diagnosis / Q000503:physiopathology*; D013116:Spinal Cord / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000503:physiopathology*; D013406:Suicide, Attempted