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Electrical injury and ALS: a systematic review of the literature
  1. Kumar Abhinav (kumar.abhinav{at}doctors.org.uk)
  1. Queen Elizabeth Hospital, United Kingdom
    1. Ammar Al-Chalabi (ammar{at}iop.kcl.ac.uk)
    1. Institute of Psychiatry, United Kingdom
      1. Tibor Hortobagyi
      1. King's College Hospital, United Kingdom
        1. P Nigel Leigh (n.leigh{at}iop.kcl.ac.uk)
        1. Institute of Psychiatry, United Kingdom

          Abstract

          Objective:Electrical injury may act as a potential precipitating or risk factor for ALS. We undertook a systematic review of the literature to assess the relationship between electrical injury and the development of ALS.

          Methods:Information for the review was obtained using five medical databases, and from manual searching of individual papers. Patients presenting with a neurological syndrome following electrical injury, including lightning, were included and were classified into four categories: ALS; progressive upper motor neuron (UMN) syndrome; progressive lower motor neuron (LMN) syndrome, and non-progressive syndrome. Linear regression and Chi square testing were used for analysis of the data.

          Results:Ninety-six individuals, comprising 44 with ALS, one with a progressive UMN syndrome, seven 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 a 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.

          Conclusion: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.

          • Amyotrophic Lateral Sclerosis
          • El Escorial Criteria
          • Electrical Injury

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