Neuropsychological changes following electrical injury

Abstract

The clinical presentation of electrical injury commonly involves physical, cognitive, and emotional complaints. Neuropsychological studies, including case reports, have indicated that electrical injury (EI) survivors may experience a broad range of impaired neuropsychological functions, although this has not been clarified through controlled investigation. In this study, we describe the neuropsychological test findings in a series of 29 EI patients carefully screened and matched to a group of 29 demographically similar healthy electricians. Participants were matched by their estimated premorbid intellectual ability. Multivariate analysis of variance was used to assess group differences in the following neuropsychological domains: attention and mental speed, working memory, verbal memory, visual memory, and motor skills. EI patients performed significantly worse on composite measures of attention/mental speed and motor skills, which could not be explained by demographic differences, injury parameters, litigation status, or mood disturbance. Results suggest that cognitive changes do occur in patients suffering from electrical injury.

Returning to Work After Electrical Injuries

“…[7][8][9][10][11][12][13] Reported psychosocial challenges include anxiety, depression, posttraumatic stress, loss of self-confidence, and feelings of anger. [7][8][9][10][11][12][13] For example, in a study examining the relationship between self-reported neuropsychological symptoms and work status, Pliskin et al 11 reported that 49% of individuals with EIs complained of slowed thinking, 44% reported memory problems, 43% felt distracted, 39% experienced increased stress/anxiety, 43% felt sadness/depression, 41% experienced attitudinal changes and 30% underwent feelings of anger. Poorer performance on psychometrical measures of sustained and divided attention, mental processing and speed have also been demonstrated in a sample of 29 electricians who experienced an EI when compared with 29 noninjured electricians matched for age, education, intelligence quotients, and occupational backgrounds.…”

“…Poorer performance on psychometrical measures of sustained and divided attention, mental processing and speed have also been demonstrated in a sample of 29 electricians who experienced an EI when compared with 29 noninjured electricians matched for age, education, intelligence quotients, and occupational backgrounds. 11 In a study examining psychiatric sequelae after EI, Ramati et al 14 documented that 78% of their total sample of 86 EI patients warranted a psychiatric assessment and 26% of these had two psychiatric diagnoses. The most prevalent psychiatric diagnoses included adjustment disorder (19%), followed by posttraumatic stress disorder alone (15%) and posttraumatic stress disorder with depression (15%).…”

Psychiatric Outcome Over a Decade After Electrical Injury

“…Two measures administered during the baseline neuropsychological evaluation were used in the current analysis: the BDI 17 and Wechsler Adult Intelligence Scale-Revised. 18 The follow-up interview included a brief survey of employment and litigation status, a neuropsychological symptom checklist (NSC) consisting of 18 common somatic, cognitive, and emotional symptoms, 8 and the Psychosocial Adjustment to Illness Scale SelfReport (PAIS-SR). 19 The PAIS-SR consists of 46 multiple-choice items assessing a subject's psychosocial functioning subsequent to medical problems.…”

“…Neuropsychological studies have documented deficits in attention and concentration, memory, and verbal learning following EI, [1][2][3][4][5][6][7][8][9] and emotional distress has been widely reported. [10][11][12] However, the extant literature describing outcomes following EI has largely relied on cross-sectional designs, 2,4,8 case studies, 1,5,6 and archival data. 7,11,13 These studies seem to suggest that EI is associated with ongoing, long-term consequences.…”

The Origin of Remote Symptoms in Electrical and Lightning Injuries: An Attempt at Explanation and a Hypothesis for Testing

“…These views fail to recognise the fact that the psychological syndrome is well described [1][2][3][4][5][6][7][8][9][10] and is consistent between victims who have had no chance of colluding or manufacturing their symptoms.…”