Neurological and neurourological complications of electrical injuries

Abstract

Electrical injury can affect any system and organ. Central nervous system (CNS) complications are especially well recognised, causing an increased risk of morbidity, while peripheral nervous system (PNS) complications, neurourological and cognitive and psychological abnormalities are less predictable after electrical injuries.

Case Report in the Brazilian Context: Cognitive and Behavioral Changes Following an Electric Injury

“…Electrical injury (EI) is the sequelae of industrial or residential accidents that involve electrical shock. Physical sequelae are common, such as burns, cardiac manifestations, or injuries due to falls (1)(2)(3). Neurological, neuropsychological, and psychiatric symptoms are also consistently found in cases of EI and may be present whether the head is a point of contact with the electrical current or not (4).…”

“…Changes in cognition are a relevant feature in EI and must be carefully investigated, given that cognitive decline can lead to loss of income, distress, inability to maintain a social life, and trouble maintaining daily activities (4,8). Neuropsychological changes in EI tend to be delayed (1,11), worsen over time (7)(8)(9), and cause loss of functionality (4,9), but the understanding of the psychobiological mechanisms involved is still limited (3,8).…”

“…Neurological, neuropsychological, and psychiatric symptoms are also consistently found in cases of EI and may be present whether the head is a point of contact with the electrical current or not ( 4 ). Electrical injury is more prevalent in men, probably due to exposure to industrial environments and jobs at construction ( 3 , 5 ). Physical and neurological sequelae have been studied more consistently in recent years, yet long-term cognitive and psychiatric disorders have not been described in the context of the Brazilian population.…”

“…One of the possible reasons for the high rates of neurological sequelae associated with electrical injuries could be the lower levels of resistance in blood vessels and nerves concerning bones and fat, which would facilitate the conduction of electrical current by the central nervous system ( 3 , 6 ). However, many other factors can be related and influence the severity of the consequences, such as the touch voltage, type of current [direct current (DC) or alternating current (AC)], the duration and path of the current through the body, and others.…”

“…However, many other factors can be related and influence the severity of the consequences, such as the touch voltage, type of current [direct current (DC) or alternating current (AC)], the duration and path of the current through the body, and others. Unfortunately, pathway effects on sequelae have not been extensively studied ( 3 ).…”