title: Neurosensory sequelae assessed by thermal and vibrotactile perception thresholds after local cold injury.
abstract: BACKGROUND
  Local freezing cold injuries are common in the north and sequelae to cold injury can persist many years. Quantitative sensory testing (QST) can be used to assess neurosensory symptoms but has previously not been used on cold injury patients.
  
  
  OBJECTIVE
  To evaluate neurosensory sequelae after local freezing cold injury by thermal and vibrotactile perception thresholds and by symptom descriptions.
  
  
  METHODS
  Fifteen patients with a local freezing cold injury in the hands or feet, acquired during military training, were studied with QST by assessment of vibrotactile (VPT), warmth (WPT) and cold (CPT) perception thresholds 4 months post-injury. In addition, a follow-up questionnaire, focusing on neurovascular symptoms, was completed 4 months and 4 years post-injury.
  
  
  RESULTS
  QST demonstrated abnormal findings in one or both affected hands for VPT in 6 patients, for WPT in 4 patients and for CPT in 1 patient. In the feet, QST was abnormal for VPT in one or both affected feet in 8 patients, for WPT in 6 patients and for CPT in 4 patients. Freezing cold injury related symptoms, e.g. pain/discomfort when exposed to cold, cold sensation and white fingers were common at 4 months and persisted 4 years after the initial injury.
  
  
  CONCLUSIONS
  Neurosensory sequelae after local freezing cold injury, in terms of abnormal thermal and/or vibration perception thresholds, may last at least 4 months after the initial injury. Symptoms such as pain/discomfort at cold exposure, cold sensations and white fingers may persist at least 4 years after the initial injury.
authors.affiliation: Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden ; Department of Occupational and Environmental Medicine, Sundsvall Hospital, Sundsvall, Sweden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Carlsson
authors.affiliation: Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Lage
authors.initials: L
authors.lastname: Burström
authors.affiliation: Division of Clinical Neurophysiology, Umeå University, Umeå, Sweden.
authors.forename: Victoria Heldestad
authors.initials: VH
authors.lastname: Lilliesköld
authors.affiliation: Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden ; Department of Occupational and Environmental Medicine, Sundsvall Hospital, Sundsvall, Sweden.
authors.forename: Tohr
authors.initials: T
authors.lastname: Nilsson
authors.affiliation: Division of Clinical Neurophysiology, Umeå University, Umeå, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Nordh
authors.affiliation: Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Jens
authors.initials: J
authors.lastname: Wahlström
mesh_terms: D003080:Cold Temperature / Q000009:adverse effects*; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000209:etiology / Q000503:physiopathology; D005627:Frostbite / Q000150:complications / Q000175:diagnosis*; D006230:Hand Injuries / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008889:Military Personnel; D058748:Pain Perception / Q000502:physiology*; D012494:Sampling Studies; D012678:Sensation Disorders / Q000175:diagnosis*; D012684:Sensory Thresholds / Q000502:physiology*; D013548:Sweden; D013697:Thermosensing / Q000502:physiology; D013997:Time Factors; D055815:Young Adult
keywords: Sweden; case series; frostbite; military; neurovascular; quantitative sensory testing