Neurosensory findings among electricians with self-reported remaining symptoms after an electrical injury: A case series.
OBJECTIVE
Symptoms described in previous studies indicate that electrical injury can cause longstanding injuries to the neurosensory nerves. The aim of the present case series was to objectively assess the profile of neurosensory dysfunction in electricians in relation to high voltage or low voltage electrical injury and the "no-let-go phenomenon".


METHODS
Twenty-three Swedish male electricians exposed to electrical injury were studied by using a battery of clinical instruments, including quantitative sensory testing (QST). The clinical test followed a predetermined order of assessments: thermal perceptions thresholds, vibration perception thresholds, tactile gnosis (the Shape and Texture Identification test), manual dexterity (Purdue Pegboard Test), and grip strength. In addition, pain was studied by means of a questionnaire, and a colour chart was used for estimation of white fingers.


RESULTS
The main findings in the present case series were reduced thermal perceptions thresholds, where half of the group showed abnormal values for warm thermal perception and/or cold thermal perception. Also, the tactile gnosis and manual dexterity were reduced. High voltage injury was associated with more reduced sensibility compared to those with low voltage.


CONCLUSIONS
Neurosensory injury can be objectively assessed after an electrical injury by using QST with thermal perception thresholds. The findings are consistent with injuries to small nerve fibres. In the clinical setting thermal perception threshold is therefore recommended, in addition to tests of tactile gnosis and manual dexterity (Purdue Pegboard).
Department of Occupational and Environmental Medicine, Faculty of Medical Sciences, Örebro University, SE 701 82 Örebro, Sweden; Department of Physiotherapy, School of Medical Sciences, Örebro University, SE 701 82 Örebro, Sweden. Electronic address: lisa.radman@regionorebrolan.se.
Lisa
L
Rådman
Department of Occupational and Environmental Medicine, Faculty of Medical Sciences, Örebro University, SE 701 82 Örebro, Sweden; School of Medical Sciences, Örebro University, SE 701 82 Örebro, Sweden. Electronic address: lars-gunnar.gunnarsson@oru.se.
Lars-Gunnar
LG
Gunnarsson
University Healthcare Research Centre, Faculty of Medicine and Health, Örebro University, SE 701 82 Örebro, Sweden. Electronic address: ylva.nilsagard@regionorebrolan.se.
Ylva
Y
Nilsagård
Department of Occupational and Environmental Medicine, Umeå University, 90187 Umeå, Sweden. Electronic address: tohr.nilsson@lvn.se.
Tohr
T
Nilsson
D000328:Adult; D000368:Aged; D002058:Burns, Electric / Q000150:complications*; D004556:Electric Injuries / Q000150:complications*; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology* / Q000503:physiopathology; D060051:Occupational Injuries / Q000150:complications*; D012684:Sensory Thresholds; D000071075:Small Fiber Neuropathy / Q000209:etiology* / Q000503:physiopathology; D013236:Stereognosis; D013548:Sweden; D013697:Thermosensing; D014110:Touch; D014732:Vibration
Manual dexterity; Small fibre neuropathy; Tactile gnosis; Thermal perception; Vibration perception thresholds; Voltage