Nerve injuries following intramuscular injections: a clinical and neurophysiological study from Northwest India

In developing countries, injections are frequently used to treat common ailments. Intramuscular injections (IMI) may damage peripheral nerves at the site of injection. Our objectives were to study the clinical features, neurophysiological findings, and outcome in patients with nerve injuries (NI) following IMI and to determine the factors affecting prognosis. We conducted a retrospective review of patients with NI following IMI, who were referred to our Neurophysiology Laboratory at Christian Medical College, Ludhiana, India, between January 1990 to December 2003. There were 36 (55%) patients with sciatic nerve palsy, 29 (44%) patients with radial nerve injury, and 1 (1%) patient with posterior femoral cutaneous nerve injury. In 57 (86%) patients, the IMI were given by uncertified medical practitioners. Needle electromyography (EMG) was analyzed in 36 patients (>or=60 days after onset). In 12 (33%) patients, there was EMG evidence of axonal damage with reinnervation, while in the other 24 (67%) patients, there was axonal damage without reinnervation. Only 18 (28%) patients had a good recovery. In conclusion, NI following IMI is a preventable iatrogenic hazard, which carries a poor prognosis.