Chapter 36 - Neurologic Complications of Thermal and Electric Burns

Abstract

Patients with extensive, deep thermal burns may suffer serious neurologic complications. Anoxic and metabolic encephalopathies are the most frequent. Central pontine myelinolysis may occur early or late in the hospital course. Gram-negative bacterial meningitis and cerebral microabscesses caused by Candida species or Staphylococcus aureus are the most common intracranial infections. Ischemic stroke is more often a complication of systemic infection or disseminated intravascular coagulation than of atherosclerosis, atrial fibrillation, or other premorbid vascular diseases. Electricity and lightning can injure any part of the central or peripheral nervous system. Current flowing through the head may cause transient loss of consciousness. Lightning strike often causes transient sensorimotor paralysis. Signs of injury of peripheral nerve or spinal cord may appear soon after electric shock or days to weeks later. Other complications, often unexplained, include intracerebral hemorrhage, ischemic stroke, and dystonia, and they, too, may be immediate or delayed in onset.