P193. Small fiber neuropathy after lightning injuries

Introduction Survivors of lightning injuries suffer from several acute or delayed neurological symptoms. As a delayed complication chronic pain syndrome and signs of polyneuropathy are common. Methods We examined 3 patients (2 male, 1 female) with clinical symptoms of parenthesis, chronic pain syndrome or other sensible sensations appearing after lightning injury in healthy patients before. Added to complete neurological work up, including electrophysiological examination and quantitative sensory testing (QST), biopsy of the skin in affected area was performed and prepared for histological examination. Results Affection of peripheral nervous system was frequent, as were chronic pain syndroms. Reduction of temperature reception could be seen in quantitative sensory testing. Results correlated with founded consistent histological pattern of a small fiber neuropathy with reduction of density of intraepidermal nerve fiber in all patients. Conclusion Next to electrophysiological examination biopsy of affected skin can help to objectify polyneuropathic sensations as a common effect of lightning strike.