Injection nerve palsy

Arindhom Kakati; Dhananjaya Bhat; Bhagavathula Indira Devi; Dhaval Shukla

doi:10.4103/0976-3147.105603

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Original Article

4 (

); 13-18

doi:

10.4103/0976-3147.105603

Injection nerve palsy

Arindhom Kakati, Dhananjaya Bhat, Bhagavathula Indira Devi, Dhaval Shukla

Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India

Address for correspondence: Dr. Dhaval Shukla Department of Neurosurgery, National Institute of Mental Health and Neurosciences Hosur Road, Bangalore, Karnataka India neurodhaval@rediffmail.com

Journal of Neurosciences in Rural Practice

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Abstract

ABSTRACT

Objective: To study the clinical profile and outcome of surgery for injection nerve palsies. Materials and Methods: This is a retrospective study of patients with INP who were treated at our institute during May 2000 to May 2009. Clinical, electroneuromyography (ENMG), and operative findings were noted. Intraoperative nerve action potential monitoring was not used in any case. Outcome of patients who were followed was reviewed. Results: INP comprised 92 (11%) of 837 nerve injury patients. Seventy one patients were children less than 16 years. The nerves involved were sciatic in 80 patients, radial in 8, and others in four. Fifty seven patients had power, grade 0/5. ENMG studies revealed absent compound muscle action potential in 64 and absent sensory nerve action potential in 67 patients. Thirty nine (42.3%) of 92 patients underwent surgery. The mean duration since injury in these patients was 5.2 months (3 months to 11 months). All underwent neurolysis. Only 18 patients who underwent surgery had a follow up of more than 3 months. Ten (55.5%) patients had good or fair outcome after surgery. Except for grade of motor deficit prior to surgery, none of the variables were found to significantly affect the outcome. Conclusion: The outcome of INP is generally good and many patients recover spontaneously. The outcome of surgery is dependent on preoperative motor power.

Keywords

Injectio

lesion in continuity

nerve injury

paralysis

Show Related Articles from PubMed

Conflicts of interest

None declared

REFERENCES

Iyer V. G., Shields C. B., . Isolated injection injury to the posterior femoral cutaneous nerve. Neurosurgery. 1989;25:835-8.
[Google Scholar]
Gilles F. H., French J. H., . Postinjection sciatic nerve palsies in infants and children. J Pediatr. 1961;58:195-204.
[Google Scholar]
Gilles F. H., Matson D. D., . Sciatic nerve injury following misplaced gluteal injection. J Pediatr. 1970;76:247-54.
[Google Scholar]
Kane A, Lloyd J, Zaffran M, Simonsen L, Kane M, . Transmission of hepatitis B, hepatitis C and human immunodeficiency viruses through unsafe injections in the developing world: Model-based regional estimates. Bull World Health Organ. 1999;77:801-7.
[Google Scholar]
Mayer M, Romain O, . Sciatic paralysis after a buttock intramuscular injection in children: An ongoing risk factor. Arch Pediatr. 2001;8:321-3.
[Google Scholar]
Villarejo F. J., Pascual A. M., . Injection injury of the sciatic nerve (370 cases) Childs Nerv Syst. 1993;9:229-32.
[Google Scholar]
Yuen E. C., So Y. T., Olney R. K., . The electrophysiologic features of sciatic neuropathy in 100 patients. Muscle Nerve. 1995;18:414-20.
[Google Scholar]
Ahuja B, . Post injection sciatic nerve injury. Indian Pediatr. 2003;40:368-9.
[Google Scholar]
Anand K, Pandav C. S., Kapoor S. K., . Injection use in a village in north India. Natl Med J India. 2001;14:143-4.
[Google Scholar]
Bhatia M, Jindal A. K., . Injection induced nerve injury: An iatrogenic tragedy. J Assoc Physicians India. 1996;44:532-3.
[Google Scholar]
Fatunde O. J., Familusi J. B., . Injection-induced sciatic nerve injury in Nigerian children. Cent Afr J Med. 2001;47:35-8.
[Google Scholar]
Kotwal A, Priya R, Thakur R, Gupta V, Kotwal J, Seth T, . Injection practices in a metropolis of North India: Perceptions, determinants and issues of safety. Indian J Med Sci. 2004;58:334-44.
[Google Scholar]
Kumar S, . Traditional Indian remedy for asthma challenged in court. BMJ. 2004;328:1457.
[Google Scholar]
Kline D. G., Kim D, Midha R, Harsh C, Tiel R, . Management and results of sciatic nerve injuries: A 24-year experience. J Neurosurg. 1998;89:13-23.
[Google Scholar]
Sharma S, Kale R, . Post injection palsy in Chhatisgarh region. Indian Pediatr. 2003;40:580-1.
[Google Scholar]
Pandian J. D., Bose S, Daniel V, Singh Y, Abraham A. P., . Nerve injuries following intramuscular injections: A clinical and neurophysiological study from Northwest India. J Peripher Nerv Syst. 2006;11:165-71.
[Google Scholar]
Shukla D. P., Bhat D. I., Devi B. I., Gopalakrishnan M. S., Moiyadi A, . Injection injuries of peripheral nerves. Indian J Neurotrauma. 2004;1:21-3.
[Google Scholar]
Yeremeyeva E, Kline D. G., Kim D. H., . Iatrogenic sciatic nerve injuries at buttock and thigh levels: The Louisiana State University experience review. Neurosurgery. 2009;65:A63-6.
[Google Scholar]
Midha R, . Mechanism and pathology of injury.Kline and Hudson’s nerve injuries: Operative results for major nerve injuries, entrapments, and tumors. (2nd ed). In: China: Saunders Elsevier; 2008. p. p. 23-42.
[Google Scholar]
Zhu Q, . Peripheral nerves injection injury: The clinical and experimental study. Zhonghua Wai Ke Za Zhi. 1992;30:522-4.
[Google Scholar]
Huang Y, Yan Q, Lei W, . Gluteal sciatic nerve injury and its treatment. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2000;14:83-6.
[Google Scholar]
Position Statement on Injection Technique , . March Available from [Last cited on 2011 May 16]
[Publisher]

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[1] Iyer V. G., Shields C. B., . Isolated injection injury to the posterior femoral cutaneous nerve. Neurosurgery. 1989;25:835-8.
[Google Scholar]

[2] Gilles F. H., French J. H., . Postinjection sciatic nerve palsies in infants and children. J Pediatr. 1961;58:195-204.
[Google Scholar]

[3] Gilles F. H., Matson D. D., . Sciatic nerve injury following misplaced gluteal injection. J Pediatr. 1970;76:247-54.
[Google Scholar]

[4] Kane A, Lloyd J, Zaffran M, Simonsen L, Kane M, . Transmission of hepatitis B, hepatitis C and human immunodeficiency viruses through unsafe injections in the developing world: Model-based regional estimates. Bull World Health Organ. 1999;77:801-7.
[Google Scholar]

[5] Mayer M, Romain O, . Sciatic paralysis after a buttock intramuscular injection in children: An ongoing risk factor. Arch Pediatr. 2001;8:321-3.
[Google Scholar]

[6] Villarejo F. J., Pascual A. M., . Injection injury of the sciatic nerve (370 cases) Childs Nerv Syst. 1993;9:229-32.
[Google Scholar]

[7] Yuen E. C., So Y. T., Olney R. K., . The electrophysiologic features of sciatic neuropathy in 100 patients. Muscle Nerve. 1995;18:414-20.
[Google Scholar]

[8] Ahuja B, . Post injection sciatic nerve injury. Indian Pediatr. 2003;40:368-9.
[Google Scholar]

[9] Anand K, Pandav C. S., Kapoor S. K., . Injection use in a village in north India. Natl Med J India. 2001;14:143-4.
[Google Scholar]

[10] Bhatia M, Jindal A. K., . Injection induced nerve injury: An iatrogenic tragedy. J Assoc Physicians India. 1996;44:532-3.
[Google Scholar]

[11] Fatunde O. J., Familusi J. B., . Injection-induced sciatic nerve injury in Nigerian children. Cent Afr J Med. 2001;47:35-8.
[Google Scholar]

[12] Kotwal A, Priya R, Thakur R, Gupta V, Kotwal J, Seth T, . Injection practices in a metropolis of North India: Perceptions, determinants and issues of safety. Indian J Med Sci. 2004;58:334-44.
[Google Scholar]

[13] Kumar S, . Traditional Indian remedy for asthma challenged in court. BMJ. 2004;328:1457.
[Google Scholar]

[14] Kline D. G., Kim D, Midha R, Harsh C, Tiel R, . Management and results of sciatic nerve injuries: A 24-year experience. J Neurosurg. 1998;89:13-23.
[Google Scholar]

[15] Sharma S, Kale R, . Post injection palsy in Chhatisgarh region. Indian Pediatr. 2003;40:580-1.
[Google Scholar]

[16] Pandian J. D., Bose S, Daniel V, Singh Y, Abraham A. P., . Nerve injuries following intramuscular injections: A clinical and neurophysiological study from Northwest India. J Peripher Nerv Syst. 2006;11:165-71.
[Google Scholar]

[17] Shukla D. P., Bhat D. I., Devi B. I., Gopalakrishnan M. S., Moiyadi A, . Injection injuries of peripheral nerves. Indian J Neurotrauma. 2004;1:21-3.
[Google Scholar]

[18] Yeremeyeva E, Kline D. G., Kim D. H., . Iatrogenic sciatic nerve injuries at buttock and thigh levels: The Louisiana State University experience review. Neurosurgery. 2009;65:A63-6.
[Google Scholar]

[19] Midha R, . Mechanism and pathology of injury.Kline and Hudson’s nerve injuries: Operative results for major nerve injuries, entrapments, and tumors. (2nd ed). In: China: Saunders Elsevier; 2008. p. p. 23-42.
[Google Scholar]

[20] Zhu Q, . Peripheral nerves injection injury: The clinical and experimental study. Zhonghua Wai Ke Za Zhi. 1992;30:522-4.
[Google Scholar]

[21] Huang Y, Yan Q, Lei W, . Gluteal sciatic nerve injury and its treatment. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2000;14:83-6.
[Google Scholar]

[22] Position Statement on Injection Technique , . March Available from [Last cited on 2011 May 16]
[Publisher]

Injection nerve palsy

Abstract

ABSTRACT

Keywords

Injectio

lesion in continuity

nerve injury

paralysis

Conflicts of interest

REFERENCES

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