Yıl: 2012 Cilt: 49 Sayı: 3 Sayfa Aralığı: 208 - 211 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Injection neuropathies of the sciatic nerve: experience of an electrophysiology laboratory and medicolegal approach in Turkey

Öz:
Amaç: Kas içi enjeksiyonlar için en çok tercih edilen alan gluteal bölgedir. Bununla beraber, ağrı, abse oluşumu, hematom oluşumu ve periferik sinir hasarı, özellikle siyatik sinir yaralanması bildirilen komplikasyonlardır. Burada, gluteal kas içi enjeksiyonlar sonrası gelişen siyatik sinir hasarında demografik, klinik ve elektrofizyolojik özelliklerin incelenmesi ve Türkiyedeki yasal prosedürlerin özetlenmesi amaçlanmıştır. Yöntem: Ocak 1995 ve Haziran 2006 arasında elektrofizyoloji bölümümüze gluteal bölgede kas içi enjeksiyon sonrası gelişen siyatik sinir yaralanmasına dair belirti ve bulgular ile başvuran 33 hastanın klinik ve elektrofizyolojik özelliklerini retrospektif olarak gözden geçirdik ve yasal süreci özetledik. Bulgular: On altı erkek (%48,5) ve 17 kadın (%51,5) hasta bulunmaktaydı. Yaş aralığı 1,5 ile 81 şeklindeydi. Sinir yaralanması ve laboratuarımıza başvuru arasındaki süre 20 gün ile 25 yıl arasındaydı. Başvurulardan 24ü yaralanmadan sonraki 6 ay içinde, 32si 1 yıl içindeydi ve sadece biri 25 yıl sonra başvurmuştu. Yaralanmadan sonraki 6 ay içinde hastaların tanı ve prognoz tayini için başvurmasına karşın daha geç dönemdeki hastalar medikolegal süreç içinde yönlendirilmişlerdi. Tüm hastalar, alt ekstremitenin tamamına yayılan yanma ve elektrik çarpması benzeri ağrılar tanımladı. Diğer belirtiler, güçsüzlük (%50), uyuşma (%9,1) ve paresteziler (%4,5) idi. Elektrofizyolojik olarak, dokuz hastada siyatik sinirin her iki dalı da etkilenmişti ve hastaların geri kalanında lateral divizyonda aksonal tutulum ön plandaydı. Sonuçlar: Enjeksiyon nöropatisi, siyatik sinir nöropatilerinin önemli bir kısmını oluşturur. En sık belirtiler, yanma şeklinde ağrı ve güçsüzlüktür. Travmaya bağlı tüm siyatik nöropatilerde, peroneal siniri besleyen liflerin daha dış kısımda ve daha yüzeyel yerleşiminden ötürü peroneal sinirin daha sıklıkla etkilendiği görülmektedir. Enjeksiyon nöropatilerinde genellikle aksonal tutulum hakimdir. Geç dönemdeki hastalar, sekelin belirlenmesi ve medikolegal süreçler nedeniyle elektrofizyoloji laboratuarına yönlendirilmektedir. Tüm tıp mensupları bu durumdaki klinik ve elektrofizyolojik bulgular ile medikolegal yaklaşımdan haberdar olmalıdır. (
Anahtar Kelime:

Konular: Nörolojik Bilimler Psikiyatri

Siyatik sinir enjeksiyon nöropatileri: bir elektrofizyoloji laboratuarının tecrübesi ve Türkiye'de medikolegal yaklaşım

Öz:
Objective: The gluteal region is usually the preferred site for intramuscular injections. However, reported complications include pain, abscess formation, hematoma formation and peripheral nerve injury, most frequently sciatic nerve injury. Here, we aimed to analyze the demographical, clinical and electrophysiological features of patients with sciatic nerve injury following gluteal intramuscular injections and to summarize the legal procedure in Turkey. Methods: We retrospectively investigated the clinical and electrophysiological features of 33 patients who were admitted to our electrophysiology department between January 1995 and June 2006 with symptoms and signs of sciatic nerve injury which appeared after intramuscular injection in the gluteal region and we reviewed the legal procedure. Results: There were 16 male (48.5%) and 17 female (51.5%) patients. Age range was between 1.5 and 81 years. The interval between nerve injury and admission to our laboratory ranged from 20 days to 25 years. 24 patients were admitted within 6 months after the injury, 32, within 1 year and, only one was admitted after 25 years. The patients who were admitted within the first 6 months after the injury, were commonly admitted for diagnosis and determination of prognosis, whereas the patients in the late periods were referred as a part of medico-legal procedure. All patients expressed burning and shock-like pain radiating to the whole lower extremity. The other symptoms were weakness (50%), numbness (9.1%), and paresthesia (4.5%). Electrophysiologically, both divisions of the sciatic nerve were affected in 9 (27.2%) and axonal involvement of the lateral division predominated in the remaining patients. Conclusion: Injection neuropathy constitutes the major part of the sciatic nerve injuries. Most frequent symptoms are burning pain and weakness. In any traumatic sciatic neuropathy, the peroneal nerve seems to be involved more frequently resulting from the more lateral and superficial location of the fibers supplying the peroneal nerve. Axonal involvement is generally predominating in injection neuropathies. Patients even in the late period are referred to the electrophysiology laboratory for determination of sequela and medico-legal procedures. All medical staff should be aware of clinical and electrophysiological findings and medicolegal approach in this condition.
Anahtar Kelime:

Konular: Nörolojik Bilimler Psikiyatri
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA GÜNDÜZ A, UZUN ADATEPE N, Alkan N, SAVRUN KARAALİ F, KIZILTAN M (2012). Injection neuropathies of the sciatic nerve: experience of an electrophysiology laboratory and medicolegal approach in Turkey. , 208 - 211.
Chicago GÜNDÜZ Ayşegül,UZUN ADATEPE NURTEN,Alkan Nevzat,SAVRUN KARAALİ Feray,KIZILTAN Meral Injection neuropathies of the sciatic nerve: experience of an electrophysiology laboratory and medicolegal approach in Turkey. (2012): 208 - 211.
MLA GÜNDÜZ Ayşegül,UZUN ADATEPE NURTEN,Alkan Nevzat,SAVRUN KARAALİ Feray,KIZILTAN Meral Injection neuropathies of the sciatic nerve: experience of an electrophysiology laboratory and medicolegal approach in Turkey. , 2012, ss.208 - 211.
AMA GÜNDÜZ A,UZUN ADATEPE N,Alkan N,SAVRUN KARAALİ F,KIZILTAN M Injection neuropathies of the sciatic nerve: experience of an electrophysiology laboratory and medicolegal approach in Turkey. . 2012; 208 - 211.
Vancouver GÜNDÜZ A,UZUN ADATEPE N,Alkan N,SAVRUN KARAALİ F,KIZILTAN M Injection neuropathies of the sciatic nerve: experience of an electrophysiology laboratory and medicolegal approach in Turkey. . 2012; 208 - 211.
IEEE GÜNDÜZ A,UZUN ADATEPE N,Alkan N,SAVRUN KARAALİ F,KIZILTAN M "Injection neuropathies of the sciatic nerve: experience of an electrophysiology laboratory and medicolegal approach in Turkey." , ss.208 - 211, 2012.
ISNAD GÜNDÜZ, Ayşegül vd. "Injection neuropathies of the sciatic nerve: experience of an electrophysiology laboratory and medicolegal approach in Turkey". (2012), 208-211.
APA GÜNDÜZ A, UZUN ADATEPE N, Alkan N, SAVRUN KARAALİ F, KIZILTAN M (2012). Injection neuropathies of the sciatic nerve: experience of an electrophysiology laboratory and medicolegal approach in Turkey. Nöropsikiyatri Arşivi, 49(3), 208 - 211.
Chicago GÜNDÜZ Ayşegül,UZUN ADATEPE NURTEN,Alkan Nevzat,SAVRUN KARAALİ Feray,KIZILTAN Meral Injection neuropathies of the sciatic nerve: experience of an electrophysiology laboratory and medicolegal approach in Turkey. Nöropsikiyatri Arşivi 49, no.3 (2012): 208 - 211.
MLA GÜNDÜZ Ayşegül,UZUN ADATEPE NURTEN,Alkan Nevzat,SAVRUN KARAALİ Feray,KIZILTAN Meral Injection neuropathies of the sciatic nerve: experience of an electrophysiology laboratory and medicolegal approach in Turkey. Nöropsikiyatri Arşivi, vol.49, no.3, 2012, ss.208 - 211.
AMA GÜNDÜZ A,UZUN ADATEPE N,Alkan N,SAVRUN KARAALİ F,KIZILTAN M Injection neuropathies of the sciatic nerve: experience of an electrophysiology laboratory and medicolegal approach in Turkey. Nöropsikiyatri Arşivi. 2012; 49(3): 208 - 211.
Vancouver GÜNDÜZ A,UZUN ADATEPE N,Alkan N,SAVRUN KARAALİ F,KIZILTAN M Injection neuropathies of the sciatic nerve: experience of an electrophysiology laboratory and medicolegal approach in Turkey. Nöropsikiyatri Arşivi. 2012; 49(3): 208 - 211.
IEEE GÜNDÜZ A,UZUN ADATEPE N,Alkan N,SAVRUN KARAALİ F,KIZILTAN M "Injection neuropathies of the sciatic nerve: experience of an electrophysiology laboratory and medicolegal approach in Turkey." Nöropsikiyatri Arşivi, 49, ss.208 - 211, 2012.
ISNAD GÜNDÜZ, Ayşegül vd. "Injection neuropathies of the sciatic nerve: experience of an electrophysiology laboratory and medicolegal approach in Turkey". Nöropsikiyatri Arşivi 49/3 (2012), 208-211.