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Burn-associated peripheral polyneuropathy. A search for causative factors
A J Margherita1, L R Robinson, D M Heimbach
1Department of Rehabilitation Medicine, Harborview Medical Center/University of Washington School of Medicine, Seattle 98195.
American Journal of Physical Medicine & Rehabilitation
|January 1, 1995
Summary
Burn-associated polyneuropathy (BAPN) is common after thermal injury, with electrophysiologic changes detectable within one week. These nerve function alterations may stem from an inflammatory cascade triggered by the burn.
Area of Science:
- Neurology
- Burn Medicine
- Electrophysiology
Background:
- Burn-associated polyneuropathy (BAPN) is a potential complication following thermal injury.
- The timing and electrophysiologic characteristics of BAPN require further elucidation.
- Understanding BAPN's onset is crucial for managing post-burn complications.
Purpose of the Study:
- To evaluate the onset of burn-associated polyneuropathy (BAPN) after thermal injury.
- To investigate the relationship between BAPN and burn severity (size and depth).
- To explore potential inflammatory markers associated with BAPN.
Main Methods:
- Nerve conduction studies were performed on 17 burned subjects at 1 week postburn and on 11 subjects at 6 weeks.
- Electrophysiologic parameters (distal latencies, conduction velocities, amplitudes) were measured in unburned limbs.
- Data were analyzed using Z scores to quantify global nerve function (Ztotal) and correlated with burn characteristics and C-reactive protein levels.
Main Results:
- Within one week postburn, significant electrophysiologic alterations indicative of BAPN were observed, including prolonged latencies, slowed motor conduction velocities, and reduced sensory nerve action potential amplitudes.
- No statistically significant correlations were found between Ztotal scores and total burn surface area or depth.
- Higher C-reactive protein levels correlated with severe neuropathy, suggesting an inflammatory component.
Conclusions:
- Burn-associated polyneuropathy (BAPN) is a common finding within the first week after thermal injury.
- Electrophysiologic evidence of BAPN manifests early, independent of burn size or depth in this cohort.
- Inflammation likely plays a role in the development of BAPN following thermal trauma.