Background: Traumatic Injection
Neuropathy (TIN) can occur because of unsafe intramuscular injection practices.
TIN presents as acute peripheral neuropathy with flaccid paralysis of the
injected limb within 24 hours after injection and is associated with pain and
hypothermia in the affected limbs. This complication is of particular concern
in countries with high rates of unnecessary injections. Objective: The main
objectives were to determine the incidence of Traumatic Injection Neuropathy (TIN)
and hospital outcome of patients within 60 days of admission. Material & Methods:
The records of all patients followed with flaccid paralysis through the WHO
program for Acute Flaccid Paralysis (AFP), concerning eradication of
poliomyelitis with the differential diagnosis including TIN in governorates in
Yemen. From 1 January 2010 to 31 December 2015 were reviewed. Those patients
suspected to be TIN were examined by a neurologist and pediatric consultant to
confirm the diagnosis. At the time of admission, specific form was designed to record demographic
characteristics, clinical finding and presentation of paralysis. All patients
follow up for 60 days. Results: During the study period, 788 patients were
diagnosed as TIN.
Of these 529 (67.1%) were males and 295 (32.9%) were females. The age of the
patients was ranged (between 1 to 15 years), and most of them 555 (70.4%) were young children of ≤5
years old and 233 (29.5%) cases were
5-15 years old. The overall incidence was 28/100,000 population. The outcome of
patients showed that 354 (44.9%) had residual paralysis. 429 (54.4%) TIN patients
improved, and 3 (0.4%) were lost, and 2
(0.3%) patients died within 60 days of follow-up. Conclusion: This study confirms that traumatic injection
neuritis is the second most common cause of Acute Flaccid Paralysis in Yemen
after Guillain-Barré Syndrome with high morbidity in children.
Cite this paper
Al-Kubati, A. S. , Mujlli, H. M. and Haroon, Z. T. (2017). Incidence of Traumatic Injection Neuritis among Children ＜15 Years Old in Yemen. Open Access Library Journal, 4, e3221. doi: http://dx.doi.org/10.4236/oalib.1103221.
Halsey, N.A. (2003) Commentary:
Poliomyelitis and Unnecessary Injections. International
Journal of Epidemiology, 32, 278-279. https://doi.org/10.1093/ije/dyg071
Eser,
F., Aktekin, L.A., Bodur, H.
and Atan, C. (2009)
Etiological Factors of Traumatic Peripheral Nerve Injuries. Neurology India, 57, 434-437. https://doi.org/10.4103/0028-3886.55614
Agha, A.A.
and
Shah, S.S. (2001) Unnecessary
Therapeutic Injections: A Cause of Physical Disability. Infectious Disease Journal of Pakistan, 10, 22-23.
Lagunju, I.A. and Okafor, O.O.
(2009) An
Analysis of Disorders Seen at the Paediatric Neurology Clinic, University
College Hospital, Ibadan, Nigeria. West
African Journal of Medicine, 28, 326-330. https://doi.org/10.4314/wajm.v28i1.48424
Mansoor,
F., Hamid, S., Mir,
T., Abdul
Hafiz, R.
and Mounts, A.
(2005) Incidence
of Traumatic Injection Neuropathy among Children in Pakistan. Eastern Mediterranean Health Journal, 11, 798.
Alonge, I.A.O. and
Akinwola, M.O. (2010) Post-Injection
Sciatic Neuropathy: A Five-Year Review of Cases Managed in a Paediatric
Hospital in Ibadan, Nigeria. AJPARS, 2,
10-13.
https://doi.org/10.4314/ajprs.v2i1.62600
Bagis, S., Adam,
M., Leblebici,
U.B., Karatas, M., Güven, A.Z. and Celiker, A.R. (2012) Sciatic
Nerve Injury due to Intramuscular Injection: Electrophysiological Findings and One-Year
Follow-Up. Turkish Journal of Medical
Sciences, 42, 913- 917.
Mishra, P.
and
Stringer, M.D. (2010) Sciatic
Nerve Injury from Intramuscular Injection: A Persistent and Global Problem. International Journal of Clinical Practice, 64, 1573-1579. https://doi.org/10.1111/j.1742-1241.2009.02177.x
Fapojuwo, O.A., Akinlade, T.S. and
Gbiri, C.A. (2008) A Three-Year
Review of Sciatic Nerve Injection Palsy in the Physiotherapy Department of a
Nigerian Specialist Hospital. African
Journal of Medicine & Medical Sciences, 37, 389-393.
Toopchizadeh, V.,
Barzegar, M.
and
Habibzadeh, A.
(2015) Sciatic
Nerve Injection Palsy in Children, Electrophysiologic Pattern and Outcome: A
Case Series Study. Iranian Journal of
Child Neurology, 9, 69-72.
