Ушкодження периферичної нервової системи при електротравмі (огляд літератури)

Electrical injury can lead to neurological consequences in affected individuals. Retrospective cohort studies have shown that in approximately 40 % of cases of high-voltage electrical injury, peripheral nerve conduction parameters were abnormal.Evidence collection. A retrospective literature search was conducted using a spatial vector descriptive model, supplemented by manual identification of relevant articles. A total of 37 recent sources were included, of which 91.9 % were published within the last 10 years and 78.4 % within the last 5 years.Evidence synthesis. Disorders of the peripheral nervous system account for approximately 90 % of the neurological consequences of electrical injury and, according to reports from burn units, significantly exceed those observed after thermal injuries. The most common complication is mononeuropathy (including carpal tunnel syndrome), while polyneuropathy and polyradiculopathy occur less frequently. Electrical burns cause both direct nerve damage and indirect injury due to post-traumatic edema. Electrical injury may result in nerve paralysis caused by peripheral nerve damage. Partial or complete loss of peripheral nerve function, typically limited to the area of local contact, is usually temporary, and full recovery can be expected if the nerve is not affected by local tissue injury. Peripheral nervous system involvement is common and affects both sensory and motor functions. Immediate symptoms often resolve and have a more favorable prognosis than delayed manifestations. Sensory dysfunction may be associated with damage to sensory nerve endings. Autonomic disorders after electrical injury occur in approximately 60 % of patients with both high- and low-voltage injuries. Clinical manifestations may include tachycardia, significant fluctuations in blood pressure, headache, anxiety, hyperhidrosis, gastrointestinal disturbances, sleep disturbances, and dyspnea. Chronic neuropathic pain (allodynia) occurs in some patients, and accurate epidemiological data are currently lacking. Some patients may report intermittent discomfort or abnormal sensations without obvious physical injury, whereas others develop severe pain associated with evident tissue damage. Conclusions. Complications affecting the peripheral nervous system may occur immediately after the injury or after a prolonged period. They are difficult to diagnose and significantly reduce patients’ quality of life. Timely nerve decompression procedures improve treatment outcomes.