Neuropsychological and emotional changes in electrical injury

Summary form only given as follows: Neuropsychological (e.g., memory, attention, language functioning, problem-solving ability) and psychiatric (primarily anxiety and depression) changes associated with electrical injury have been described in the last several decades; however, there have been few systematic neuropsychologic investigations, and no consistent constellation of symptoms has emerged across studies. Many patients develop neuropsychological impairment following electrical injury. It remains unclear to what extent neuropsychological disturbance is attributable to possible neuropathological effects of the electrical injury, to poor post-injury emotional adjustment, or to some combination of these factors. Here, the results of the authors´ neuropsychological investigation of electrical injury are reported. Two groups of electrical injury patients (acute and post-acute) were given a comprehensive battery of neuropsychological tests, as well as measures of emotional/personality function. The acute-injury (Al) patient group was comprised of 21 electrical injury victims who were evaluated as inpatients or shortly after discharge, at an average of 17.2 days after their injuries (range=1-57 days). The post-acute (PA) group was comprised of 22 electrical injury victims who were evaluated at an average of 24.9 months (range=3.5-53.2 months) following their injuries. The 2 groups did not differ on age, sex, years of education or full-scale IQ. The results of the study to date indicate that mild memory deficits were present in the PA patients, while neuropsychological performance of the AI patients was generally in the average range. Poor memory performance in the PA group seems to be due to reduced rates of learning, although the PA group also reported significantly higher levels of emotional distress, which was strongly correlated to memory performance. The authors suggest that neuropsychological functioning is significantly related to poor emotional adjustment in the later stages of recovery from electrical injury, and that substantial differences exist between acutely injured patients and those presenting with sequelae from injuries several years after their accidents. The significance of these findings in the context of immediate and delayed electrical injury syndromes is discussed and results of the authors´ longitudinal investigation of acutely injured patients is presented