Which neurologic findings are characteristic of electrical injuries?

Updated: Mar 09, 2020
  • Author: Tracy A Cushing, MD, MPH, FACEP, FAWM; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Most acute CNS or spinal deficits resulting from electrical injuries are due to secondary blunt trauma or burns. Often, the patient has transient confusion, amnesia, and impaired recall of events if not frank loss of consciousness. Direct effects of electrical current are most severe if the respiratory control center of the brainstem is affected resulting in respiratory arrest. Current may also cause seizure or direct spinal cord injury if there is hand-to-hand flow. Spinal cord injury can also result from direct current effects or blunt trauma. Unless a patient is completely lucid with full recollection of the events, initial C-spine immobilization is indicated.

Currents cause acute muscle tetany at relatively low currents and frequencies, like those found in most households. Muscle tetany causes victims to grasp the source, prolonging contact time, and can also paralyze respiratory muscles resulting in asphyxiation.

Long-term neurologic complications include seizures, peripheral nerve damage, delayed spinal cord syndromes, subacute infarcts, [29] and psychiatric problems from depression to aggressive behavior.


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