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KMID : 0378019890320040073
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New Medical Journal
1989 Volume.32 No. 4 p.73 ~ p.83
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A clinical observation of iatrogenic peripheral neuropathy
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Abstract
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Peripheral nerves are easily damaged by various causes due to their anatomical and histologi .1 characteristics. Besides the direct causes, iatrogenic peripheral neuropathies have been report-..
For the purpose to prevent the iatrogenic neuropathies, a retrospective analysis of 60 iatroge ´c peripheral neuropathies out of 468 peripheral neuropathies from September of 1985 to Au-- st of 1988 in the Department of Rehabilitation Medicine of Korea university Haewha hospital as carried out. They were confirmed by clinical histroy, physical-examination and the electrodiagnosis., The results are as follows
1. The total 60 cases were composed of 37 males(61.7%) and 23 females(38.8%) aging f .m 2 months to 50 yrs.
2. The involved nerves were 25(41.6%) in lower extremity, 22(36.7%) in upper extremity . d 13(21.7%) in face.
The most frequently damaged nerve was sciatic nerve (30.3%) followed by radial (23.3´ o) ,
facial (21.7%) , brachial plexus (10%) and common peroneal nerves (10%) in order.
3. The damage was caused by compression (35.5%), operation or therapeutic maneuver (31.7´o),
injection(23.3%) and traction(10%).
4. The causes according to the nerves were facial nerve by operation (100%), radial nerve by compression(92.7%), brachial plexus injury by traction(83.3%), sciatic neuropathy by injection (77.8%) and common peroneal neuropathy by compression (83.3%).
5. Five cases were due to operative posture. Radial and ulnar neuropathy were developed by compression after thoracotomy and laminectomy, respectively. Common peroneal neuropathy was developed by lower extremity posture over cholecystectomy. Brachial plexus in, , obturator neuropathy were developed by traction over pancreatectomy and delivery, respectively,
6. The neurapraxia resulted mainly from tourniquet or body weight compression in 13 r. dial nerves out of 21 cases of compression. The axonotmesis resulted from cast compression in - 4 common peroneal nerve, injection in 13 sciatic nerve, operation in 7 facial nerve and lithotomy traction in 1 obturator nerve. The neurotmesis resulted from mass resection in 4 facial and 2 sciatic nerves.
7. The duration from onset to examination was within one month in facial nerve(64.3%), .-6 months in upper extremity(72.7%), and within one month(40.0%) and 1-6 months(36.6%) in lower extremity.
8. The follow up study in 19 cases out of 44 cases of.axonotmesis or neurotmesis showed that complete clinical recovery in 67% of "facial neuropathy, 50% of upper and 58.3% of lower extremities neuropathy.
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