Citation

Finsterer J. J. Korean Med. Sci. 2023; 38(36): e307.

Copyright

(Copyright © 2023, Korean Academy of Medical Science)

DOI

10.3346/jkms.2023.38.e307

PMID

37698213

Abstract

We read with interest Kim et al.'s article1 on a 27-yo woman with traumatic lesions of the sciatic nerves, abdominal muscles, and lower limb muscles during the crowd crush in Itaewon on the 29th of October 2023 during an urban mass Halloween celebration. Nerve conduction studies (NCSs) and needle electromyography (EMG) revealed lesions of the left sciatic nerve and the right peroneal nerve.1 The study is excellent but has limitations that should be extensively discussed.

The major limitation of the study is that no explanation was provided as to why the patient suffered traumatic nerve and muscle lesions in the abdomen and lower limbs, but not in the upper limbs, head, trunk, or chest. It was reported that the female fell, lay on the road and was overrun by hundreds of people for 1.5 hours.1 One would expect the entire body, including the head, thorax, spine and upper limbs, to be damaged rather than just the lower limbs. It should be explained why the index patient suffered trauma only to the lower limbs and not to other parts of the body. Were NCSs and EMGs of upper extremity muscles normal?

A second limitation of the study is that seizure was not excluded as a cause of hyper-creatine-kinase (CK)emia. The patient was sleepy for several hours on admission and had mild hyper-CKemia on admission, which increased to 16,519 IU/L on the third hospital day.1 Based on these findings, it would have been imperative to exclude a postictal condition by recording an electroencephalogram (EEG) in order to detect possible epileptiform discharges. In addition, cerebral CT is not sufficient to rule out traumatic brain injury (TBI). Has the patient ever had a cerebral MRI?...

Language: en

Keywords

Accidents; Humans; *Crush Injuries; *Mass Casualty Incidents; *Nerve Compression Syndromes; Peroneal Nerve; Survivors