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http://dx.doi.org/10.3344/kjp.2021.34.1.124

The relationship between nerve conduction studies and neuropathic pain in sciatic nerve injury due to intramuscular injection  

Fidanci, Halit (Department of Neurology, Division of Clinical Neurophysiology, Adana City Training and Research Hospital)
Ozturk, Ilker (Department of Neurology, Adana City Training and Research Hospital)
Publication Information
The Korean Journal of Pain / v.34, no.1, 2021 , pp. 124-131 More about this Journal
Abstract
Background: Sciatic nerve injury due to intramuscular injection (SNIII) is still a health problem. This study aimed to determine whether there is a correlation between neuropathic pain and electrodiagnostic findings in SNIII. Methods: Patients whose clinical and electrodiagnostic findings were compatible with SNIII participated in this retrospective cohort study. Compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) amplitudes of the sural, superficial peroneal, peroneal, and tibial nerves were graded from 1 to 4. Leeds assessment of neuropathic symptoms and signs scale (LANSS) was applied to all patients. Results: Forty-eight patients were included in the study, 67% of whom had a LANSS score ≥ 12. Sural SNAP amplitude abnormalities were present in 8 (50%) out of 16 patients with a LANSS score < 12, and 28 (87.5%) out of 32 patients with a LANSS score ≥ 12, with significant differences between the groups (P = 0.011). There was a positive correlation between the LANSS score and the sural SNAP amplitude grading (P = 0.001, r = 0.476). A similar positive correlation was also found in the LANSS score and the tibial nerve CMAP amplitude grading (P = 0.004, r = 0.410). Conclusions: This study showed a positive correlation between the severity of tibial nerve CMAP/sural SNAP amplitude abnormality and LANSS score in SNIII. Neuropathic pain may be more common in SNIII patients with sural nerve SNAP amplitude abnormality.
Keywords
Action Potentials; Electrodiagnosis; Electromyography; Injections, Intramuscular; Neural Conduction; Neuralgia; Sciatic Nerve; Sciatic Neuropathy; Sural Nerve; Tibial Nerve;
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1 Sugimoto T, Ichikawa H, Hijiya H, Mitani S, Nakago T. c-Fos expression by dorsal horn neurons chronically deafferented by peripheral nerve section in response to spared, somatotopically inappropriate nociceptive primary input. Brain Res 1993; 621: 161-6.   DOI
2 Hu P, Bembrick AL, Keay KA, McLachlan EM. Immune cell involvement in dorsal root ganglia and spinal cord after chronic constriction or transection of the rat sciatic nerve. Brain Behav Immun 2007; 21: 599-616.   DOI
3 Pei BA, Zi JH, Wu LS, Zhang CH, Chen YZ. Pulsed electrical stimulation protects neurons in the dorsal root and anterior horn of the spinal cord after peripheral nerve injury. Neural Regen Res 2015; 10: 1650-5.   DOI
4 Turco CV, El-Sayes J, Savoie MJ, Fassett HJ, Locke MB, Nelson AJ. Short- and long-latency afferent inhibition; uses, mechanisms and influencing factors. Brain Stimul 2018; 11: 59-74.   DOI
5 Cengiz B, Fidanci H, Kiyak Keceli Y, Baltaci H, KuruoGlu R. Impaired short- and long-latency afferent inhibition in amyotrophic lateral sclerosis. Muscle Nerve 2019; 59: 699-704.   DOI
6 Kim SJ, Kim WR, Kim HS, Park HW, Cho YW, Jang SH, et al. Abnormal spontaneous activities on needle electromyography and their relation with pain behavior and nerve fiber pathology in a rat model of lumbar disc herniation. Spine (Phila Pa 1976) 2011; 36: E1562-7.   DOI
7 Mishra P, Stringer MD. Sciatic nerve injury from intramuscular injection: a persistent and global problem. Int J Clin Pract 2010; 64: 1573-9.   DOI
8 Jung Kim H, Hyun Park S. Sciatic nerve injection injury. J Int Med Res 2014; 42: 887-97.   DOI
9 Yuen EC, So YT, Olney RK. The electrophysiologic features of sciatic neuropathy in 100 patients. Muscle Nerve 1995; 18: 414-20.   DOI
10 Tak SR, Dar GN, Halwai MA, Mir MR. Post-injection nerve injuries in Kashmir: a menace overlooked. J Res Med Sci 2008; 13: 244-7.
11 Yucel A, Senocak M, Kocasoy Orhan E, Cimen A, Ertas M. Results of the Leeds assessment of neuropathic symptoms and signs pain scale in Turkey: a validation study. J Pain 2004; 5: 427-32.   DOI
12 Fidanci H, Ozturk I, Koyluoglu AC, Yildiz M, Buturak S, Arlier Z. The needle electromyography findings in the neurophysiological classification of ulnar neuropathy at the elbow. Turk J Med Sci 2020; 50: 804-10.   DOI
13 Fidanci H, Ozturk I, Koyluoglu AC, Yildiz M, Arlier Z. Bilateral nerve conduction studies must be considered in the diagnosis of sciatic nerve injury due to intramuscular injection. Neurol Sci Neurophysiol 2020; 37: 94-9.   DOI
14 Senes FM, Campus R, Becchetti F, Catena N. Sciatic nerve injection palsy in the child: early microsurgical treatment and long-term results. Microsurgery 2009; 29: 443-8.   DOI
15 Bridges D, Thompson SW, Rice AS. Mechanisms of neuropathic pain. Br J Anaesth 2001; 87: 12-26.   DOI
16 Small SP. Preventing sciatic nerve injury from intramuscular injections: literature review. J Adv Nurs 2004; 47: 287-96.   DOI
17 Gentili F, Hudson AR, Hunter D. Clinical and experimental aspects of injection injuries of peripheral nerves. Can J Neurol Sci 1980; 7: 143-51.   DOI
18 Yeremeyeva E, Kline DG, Kim DH. Iatrogenic sciatic nerve injuries at buttock and thigh levels: the Louisiana State University experience review. Neurosurgery 2009; 65(4 Suppl): A63-6.   DOI
19 Kline DG, 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.   DOI
20 Lee BH, Won R, Baik EJ, Lee SH, Moon CH. An animal model of neuropathic pain employing injury to the sciatic nerve branches. Neuroreport 2000; 11: 657-61.   DOI
21 Kerstman E, Ahn S, Battu S, Tariq S, Grabois M. Neuropathic pain. Handb Clin Neurol 2013; 110: 175-87.   DOI
22 England JD, Happel LT, Kline DG, Gamboni F, Thouron CL, Liu ZP, et al. Sodium channel accumulation in humans with painful neuromas. Neurology 1996; 47: 272-6.   DOI
23 Erichsen HK, Blackburn-Munro G. Pharmacological characterisation of the spared nerve injury model of neuropathic pain. Pain 2002; 98: 151-61.   DOI
24 England JD, Gamboni F, Ferguson MA, Levinson SR. Sodium channels accumulate at the tips of injured axons. Muscle Nerve 1994; 17: 593-8.   DOI
25 Saito T, Yamada T, Hasegawa A, Matsue Y, Emori T, Onishi H, et al. Recovery functions of common peroneal, posterior tibial and sural nerve somatosensory evoked potentials. Electroencephalogr Clin Neurophysiol 1992; 85: 337-44.   DOI
26 Truini A, Padua L, Biasiotta A, Caliandro P, Pazzaglia C, Galeotti F, et al. Differential involvement of A-delta and Abeta fibres in neuropathic pain related to carpal tunnel syndrome. Pain 2009; 145: 105-9.   DOI
27 Oteo-Alvaro A, Marin MT. Predictive factors of the neuropathic pain in patients with carpal tunnel syndrome and its impact on patient activity. Pain Manag 2018; 8: 455-63.   DOI
28 Katirji MB, Wilbourn AJ. Common peroneal mononeuropathy: a clinical and electrophysiologic study of 116 lesions. Neurology 1988; 38: 1723-8.   DOI
29 DiDomenico LA, Masternick EB. Anterior tarsal tunnel syndrome. Clin Podiatr Med Surg 2006; 23: 611-20.   DOI
30 Barraza-Sandoval G, Casanova-Molla J, Valls-Sole J. Neurophysiological assessment of painful neuropathies. Expert Rev Neurother 2012; 12: 1297-309.   DOI
31 Oncel C, Bir LS, Sanal E. The relationship between electrodiagnostic severity and Washington Neuropathic Pain Scale in patients with carpal tunnel syndrome. Agri 2009; 21: 146-8.
32 Ortiz-Corredor F, Calambas N, Mendoza-Pulido C, Galeano J, Diaz-Ruiz J, Delgado O. Factor analysis of carpal tunnel syndrome questionnaire in relation to nerve conduction studies. Clin Neurophysiol 2011; 122: 2067-70.   DOI
33 Gursoy AE, Kolukisa M, Yildiz GB, Kocaman G, Celebi A, Kocer A. Relationship between electrodiagnostic severity and neuropathic pain assessed by the LANSS pain scale in carpal tunnel syndrome. Neuropsychiatr Dis Treat 2013; 9: 65-71.   DOI
34 Halac G, Topaloglu P, Demir S, Cikrikcioglu MA, Karadeli HH, Ozcan ME, et al. Ulnar nerve entrapment neuropathy at the elbow: relationship between the electrophysiological findings and neuropathic pain. J Phys Ther Sci 2015; 27: 2213-6.   DOI