title: Peripheral nerve compression associated with low-voltage electrical injury without associated significant cutaneous burn.
abstract: Although peripheral-nerve injury has been described as clearly related to electrical injury, that electrical injury is usually associated with third- and often fourth-degree burns. The report presented here describes three cases of low-voltage electrical injury with associated peripheral-nerve symptoms but without clinically significant cutaneous burns. The symptoms and clinical findings resembled peripheral-nerve compression. The presence of these symptoms and findings in the upper- and lower-extremities and the presence of bilateral involvement suggest a systemic electrical injury that resembles a peripheral neuropathy. Symptoms were relieved by the decompression of nerves at multiple sites in each extremity. Perineurial fibrosis was identified at the time of nerve decompression. It is proposed that the electrical injury causes maximal heat production at areas of minimal limb cross-sectional area. In these areas, the peripheral nerve is in close proximity to bone and fibrous tissue. This results in perineurial fibrosis and symptoms of a compressive peripheral neuropathy.
authors.affiliation: Division of Plastic and Reconstructive Surgery and the Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Smith
authors.forename: Thomas
authors.initials: T
authors.lastname: Muehlberger
authors.forename: A Lee
authors.initials: AL
authors.lastname: Dellon
mesh_terms: D000328:Adult; D019299:Decompression, Surgical; D004556:Electric Injuries / Q000150:complications* / Q000175:diagnosis; D005121:Extremities / Q000294:innervation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D009460:Neurologic Examination; D010525:Peripheral Nerves / Q000473:pathology / Q000601:surgery; D011312:Pressure; D012684:Sensory Thresholds