Severe multiple mononeuropathy in patients with major thermal burns

Multiple mononeuropathy after thermal burns covering greater than 40% total body surface area occurred in nine of 121 of our burn center admissions for an incidence of 7.4%. The number of nerves involved per patient ranged from three to seven, with the average being 4.9. Upper-extremity nerves were more commonly involved than were lower extremity nerves (33 versus 11). All patients had burns over the involved areas. The source was believed to be due to a multiple crush syndrome, in which multiple different neuropathic factors in each patient summate to cause a multiple mononeuropathy. The outcome with conservative treatment was variable, with lower-extremity nerve lesions having a very good outcome and upper-extremity lesions not having as good an outcome, particularly when the median nerve was affected.