A three year review of sciatic nerve injection palsy in the physiotherapy department of a Nigerian Specialist Hospital.

Abstrak

Sciatic Nerve palsy associated with intramuscular injection is a major cause of disability among children under 6-years old in the developing Countries. A retrospective study was conducted with an objective to review cases of all patients with Injection induced sciatic nerve palsy managed at the Physiotherapy Department, State Specialist Hospital, Akure Ondo State over a period of 3 years (January 2004 and December 2006). The case notes of these patients were reviewed and the details of the patients’ sex, age and presentations were obtained. Records of 160 patients presenting with Sciatic Nerve Injection Palsy were studied. Males accounted for 60% while 40% were females. They were aged from 3 months to 70 years with paediatric cases accounting for 90% of cases. All of the patients had intramuscular injections following febrile illness. Muscle paralysis with foot drop accounted for 41% cases while 59% had varying degrees of muscle paresis, without foot drop, and 4% had equinovarus deformity as a complication of the paralytic foot drop. Sciatic Nerve Injection Palsy especially in children is a common referral to the Physiotherapy Clinic. There is therefore need for caution in the administration of gluteal intramuscular injections particularly in children.

Keywords: Sciatic, nerve, injection, paralysis, physiotherapy

Résumé
La paralysie du nerf sciatique associée a l injection intramusculaire est une cause majeure parmi les enfants de moins de 6 ans dans les pays sous-développés : une étude rétrospective était conduite dans l’objectif de revoir les cas des patients ayant une injection induisant la paralysie du nerf sciatique soignée dans le département de physiothérapie á l’hôpital des spécialistes v de la province ; Akure dans l’état d’Ondo, durant 3 ans de Janvier 2004 décembre 2006. Les registres des patients étaient revus et d’autres détails anthropométriques étaient obtenues : Les données de 160 patients souffrant d’une paralysie du nerf sciatique ont été étudiés. Ils y avaient 60 % de males et 40 % de femelles, ages entre 3 á 70 ans avec des patients pédiatriques de 90 %. Tous les patients avaient reçu des injections intramusculaires suivi de la fièvre, la paralysie des muscles avec une paralysie de la jambe et 4 % avaient des déformations comme complications de la paralysie. Les patients ayant la paralysie du nerf sciatique sont très communément referés en physiothérapie clinique. Il est donc nécessaire d’être prudent dans l’administration des injections intramusculaires gluteale chez les enfants.

Correspondence: Mr. Oluseun Akinleye Fapojuwo, Department of Physiotherapy, Lagos University Teaching Hospital, Lagos, Nigeria. Email: seunfapojuwo@yahoo.com

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Referensi

Alyward BR, Nshimirimana D, Gasasira A, Heymann D, Kabore A and Wahdan MH. Polio Eradication: Africa Expands Immunization Campaigns to protect from spread of Poliovirus. MERA 2005; 3:7– 8.

Sharma S and Kale R. : Post Injection Palsy in Chhatisgarh Region. Ind Paed 2003; 40: 580-581.

Kane A, Lloyd J, Zaffran M, Simonsen L and Kane M. Transmission of Hepatitis B, Hepatitis C and HIV through Unsafe Injections in the Developing World. Bull World Health Organ 1999; 77: 801- 807.

Azar M and Irshad M. Radial Nerve Palsy. An Analysis of 50 Cases. J Coll Physicians Surg Pak 2001; 11: 417-420

Hutin YJF, Hauri AM and Amstrong GL. Use of Injections in Health Care settingsWorldwide 2000: Literature Review and Regional Estimates. Bri Med J 2003; 327:1075-1080

Simonsen L, Kane A, Lloyd J, Zaffran M and Kane M. Unsafe injections in the developing world and transmission of Blood Borne Pathogens: A Review. Bull World Health Organ 1999; 77: 789-800

Hutin YJF and Chen RT. Injection Safety: A Global Challenge. Bull World Health Organ 1999; 77: 787- 788.

Mansoor F. Case Definition of Injection Neuropathy. Pakistan J Med Res 2004; 43 (3): 1- 8

Miller MA and Pisani E. The Cost of Unsafe Injections. Bull World Health Organ 1999; 77: 808- 811

Sarker PK, Pan GD, Biswas SK and Mukherjee PK. Ideal Technique and Sites for Intramuscular Injections in Infants and Children. Paediatr Surg Int 1989; 4: 140-142.

Kline GD, Kim D, Midha R, Harsh C and Tiel R. Management and Results of Sciatic Nerve Injuries: A 24- Year Experience. J Neurosurg 1998; 89(7): 13- 23.

Napontez M and Ruszkowski K. Paralytic Foot Drop and Gluteal Fibrosis after Intramuscular Injections. J Bone Joint Surg (Br) 1993; 75-B: 83-85.

Kline DG and Hudson, AR. Nerve Injuries. Operative Results for Major Injuries, Entrapment, and Tumors. Philadelphia: WB Saunders. 1995.

Pandian JD, Bose S, Daniel V, Singh Y and Abraham AP. Nerve Injuries following Intramuscular injections: A clinical and Neurophysiological Study from Northwest India. J Peripher Nerv Syst 2006; 11: 165.

Fatunde OJ and Familusi JB. Injection- Induced Sciatic Nerve Injury in Nigerian Children. Centr Afr J Med 2001; 47: 35- 38.

Hamzat TH and Omotade TT. Acute Flaccid Paralysis: A Five-Year Review of Cases Managed by Physiotherapy at the University College Hospital, Ibadan. Afr J Health Sci 2006; 13: 28-32.

Ohaegbulam, SC. Peripheral Nerve Injuries from Intramuscular Injection of Drugs. West Afr J Pharmacol Drug Res 1976; 3: 161-167.