Neurosensory sequelae assessed by thermal and vibrotactile perception thresholds after local cold injury

Abstract

Background. Local freezing cold injuries are common in the north and sequelae to cold injury can persist many years. Quantitative sensory testing (QST) can be used to assess neurosensory symptoms but has previously not been used on cold injury patients. Objective. To evaluate neurosensory sequelae after local freezing cold injury by thermal and vibrotactile perception thresholds and by symptom descriptions. Design. Fifteen patients with a local freezing cold injury in the hands or feet, acquired during military training, were studied with QST by assessment of vibrotactile (VPT), warmth (WPT) and cold (CPT) perception thresholds 4 months post-injury. In addition, a follow-up questionnaire, focusing on neurovascular symptoms, was completed 4 months and 4 years post-injury. Results. QST demonstrated abnormal findings in one or both affected hands for VPT in 6 patients, for WPT in 4 patients and for CPT in 1 patient. In the feet, QST was abnormal for VPT in one or both affected feet in 8 patients, for WPT in 6 patients and for CPT in 4 patients. Freezing cold injury related symptoms, e.g. pain/ discomfort when exposed to cold, cold sensation and white fingers were common at 4 months and persisted 4 years after the initial injury. Conclusions. Neurosensory sequelae after local freezing cold injury, in terms of abnormal thermal and/or vibration perception thresholds, may last at least 4 months after the initial injury. Symptoms such as pain/ discomfort at cold exposure, cold sensations and white fingers may persist at least 4 years after the initial injury. © 2014 Daniel Carlsson et al.