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Electrical injury and amyotrophic lateral sclerosis: a systematic review of the literature
  1. Kumar Abhinav1,
  2. Ammar Al-Chalabi2,
  3. Tibor Hortobagyi3,
  4. P Nigel Leigh4
  1. 1Queen Elizabeth Hospital, London, UK
  2. 2Institute of Psychiatry, London, UK
  3. 3King’s College Hospital, London, UK
  4. 4Institute of Psychiatry, London, UK
  1. Correspondence to:
 Professor P Nigel Leigh
 MRC Centre for Neurodegeneration Research, Department of Clinical Neuroscience, King’s College London, Institute of Psychiatry, PO 41 Academic Neurosciences Centre, London SE5 8AF, UK;n.leigh{at}iop.kcl.ac.uk

Abstract

Electrical injury may act as a potential precipitating or risk factor for amyotrophic lateral sclerosis (ALS). A systematic review of the literature was undertaken to assess the relationship between electrical injury and the development of ALS. Information for the review was obtained using five medical databases, and from manual searching of individual papers. Patients presenting with a neurological syndrome after electrical injury, including lightning, were included and classified into four categories: ALS; progressive upper motor neurone (UMN) syndrome; progressive lower motor neurone (LMN) syndrome; and non-progressive syndrome. Linear regression and χ2testing were used for analysis of the data. 96 individuals, comprising 44 with ALS, 1 with a progressive UMN syndrome, 7 with a progressive LMN syndrome and 44 with a non-progressive syndrome, were identified from 31 papers with publication dates between 1906 and 2002. The median interval between electrical injury and disease onset was 2.25 years for all progressive syndromes and just over 1 week for the non-progressive syndrome. The more severe the shock (excluding lightning), the more likely individuals were to have a non-progressive motor syndrome. A non-progressive spinal cord syndrome is associated with more severe electrical injury. Overall, the evidence reviewed does not support a causal relationship between ALS and electric shock.

  • ALS, amyotrophic lateral sclerosis
  • LMN, lower motor neurone
  • MND, motor neurone disease
  • UMN, upper motor neurone

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Footnotes

  • Published Online First 10 November 2006

  • Competing interests: None.

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