Korean J Pain.  2021 Jan;34(1):124-131. 10.3344/kjp.2021.34.1.124.

The relationship between nerve conduction studies and neuropathic pain in sciatic nerve injury due to intramuscular injection

• Fidancı H
• Öztürk

• KMID: 2510319
• DOI: http://doi.org/10.3344/kjp.2021.34.1.124

Abstract

Background
Sciatic nerve injury due to intramuscular injection (SNIII) is still a health problem. This study aimed to determine whether there is a correlation between neuropathic pain and electrodiagnostic findings in SNIII.
Methods
Patients whose clinical and electrodiagnostic findings were compatible with SNIII participated in this retrospective cohort study. Compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) amplitudes of the sural, superficial peroneal, peroneal, and tibial nerves were graded from 1 to 4. Leeds assessment of neuropathic symptoms and signs scale (LANSS) was applied to all patients.
Results
Forty-eight patients were included in the study, 67% of whom had a LANSS score ≥ 12. Sural SNAP amplitude abnormalities were present in 8 (50%) out of 16 patients with a LANSS score < 12, and 28 (87.5%) out of 32 patients with a LANSS score ≥ 12, with significant differences between the groups (P = 0.011). There was a positive correlation between the LANSS score and the sural SNAP amplitude grading (P = 0.001, r = 0.476). A similar positive correlation was also found in the LANSS score and the tibial nerve CMAP amplitude grading (P = 0.004, r = 0.410).
Conclusions
This study showed a positive correlation between the severity of tibial nerve CMAP/sural SNAP amplitude abnormality and LANSS score in SNIII. Neuropathic pain may be more common in SNIII patients with sural nerve SNAP amplitude abnormality.

Keyword

Action Potentials; Electrodiagnosis; Electromyography; Injections; Intramuscular

Figure

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  Fig. 1 Intramuscular (IM) agents associated with sciatic nerve injury.

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  Fig. 2 Compound muscle action potential (CMAP)/Sensory nerve action potential (SNAP) amplitude abnormalities of nerves in patients with total score of Leeds assessment of neuropathic symptoms and signs scale (LANSS-T) score < 12 and LANSS-T score ≥ 12. The Pearson’s chi-squared and Fisher’s exact tests were used. A P value of less than 0.05 was considered significant. EDB: extensor digitorum brevis, TA: tibialis anterior.

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  Fig. 3 Correlation between sural sensory nerve action potential (SNAP) amplitude grading and total score of Leeds assessment of neuropathic symptoms and signs scale (LANSS-T) score of the patients.

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  Fig. 4 Correlation between tibial nerve compound muscle action potential (CMAP) amplitude grading and total score of Leeds assessment of neuropathic symptoms and signs scale (LANSS-T) score of the patients.

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