ABSTRACT
OBJECTIVE: In the light of previous reports, to examine the possibility that professional diving might cause abnormalities of the retina and choroid. METHODS: The retinal fluorescein angiograms of 55 Royal Naval divers and 24 non-diver servicemen were compared. RESULTS: No differences were found between divers and non-divers and the prevalence of abnormalities was not correlated with diving experience. CONCLUSION: In contrast to previous reports, there seem, at least in naval personnel, to be no ocular consequences of diving.
Subject(s)
Diving/adverse effects , Retinal Diseases/etiology , Adult , Fluorescein Angiography , Humans , Male , Middle Aged , Pigment Epithelium of Eye/pathology , Regression Analysis , Retinal Diseases/diagnosis , Visual Acuity , Visual FieldsABSTRACT
OBJECTIVE: To determine whether divers with histories of neurological decompression illness are electroencephalographically distinguishable from non-divers. METHODS: The electroencephalograms (EEGs) from 68 divers with histories of neurological decompression illness and 45 non-diver controls were examined independently by two clinical neurophysiologists. RESULTS: The diver and non-diver groups were electroencephalographically indistinguishable. CONCLUSION: There is no electroencephalographic evidence for the existence of cerebral dysfunction in divers with histories of decompression illness.
Subject(s)
Brain Diseases/etiology , Decompression Sickness/physiopathology , Diving/adverse effects , Electroencephalography , Adult , Brain Diseases/diagnosis , Decompression Sickness/etiology , Humans , Middle AgedABSTRACT
OBJECTIVE: To examine the possibility that subclinical damage may persist after clinical recovery from neurological decompression illness. METHODS: The neuraxes of 71 divers with medical histories of neurological decompression illness and 37 non-diver controls were examined by recording the somatosensory evoked potentials produced on stimulation of the posterior tibial and median nerves. RESULTS: Although the tests gave some objective support for the presence of "soft" residual neurological symptoms and signs, no evidence was given for the presence of subclinical damage. CONCLUSIONS: The contention that neurological damage persists after full clinical recovery from the neurological decompression illness was not supported.
Subject(s)
Decompression Sickness/complications , Diving/adverse effects , Adult , Decompression Sickness/physiopathology , Diving/physiology , Evoked Potentials, Somatosensory , Female , Humans , Male , Median Nerve/physiology , Middle Aged , Neurologic Examination , Peripheral Nervous System Diseases/etiology , Peripheral Nervous System Diseases/physiopathology , Reaction Time , Tibial Nerve/physiology , Time FactorsABSTRACT
This review considers the important role of experimental and clinical neurophysiologic techniques in the investigation of diving-related illness. The invasive monitoring of neural function using evoked potentials has been central to the creation of animal models of neurologic decompression illness (DCI). Such models have produced important insights into the nature of DCI and have reduced the empiricism of treatment protocols. However, caution is required in the application of neurophysiologic data from animal models of the disease to human DCI. Conflicting evidence exists for the usefulness of electroencephalographic and evoked potential studies in the investigation of acute neurologic DCI in man. Some neurophysiologic evidence has been produced to support the contention that diving may cause subclinical injury to the central nervous system.
Subject(s)
Decompression Sickness/physiopathology , Disease Models, Animal , Diving/physiology , Electroencephalography , Evoked Potentials, Somatosensory/physiology , Animals , Decompression Sickness/therapy , Diving/adverse effects , Dogs , Evoked Potentials, Auditory, Brain Stem/physiology , Humans , Spinal Cord Diseases/physiopathology , Spinal Cord Diseases/therapyABSTRACT
Somatosensory evoked potentials recorded over the scalp in response to posterior tibial nerve stimulation may provide a useful means of assessing the integrity of the neuraxis during the treatment of neurological decompression illness (DCI). The neurophysiological assessment of a case of DCI is described.
Subject(s)
Decompression Sickness/physiopathology , Evoked Potentials, Somatosensory/physiology , Adult , Diving , Humans , Male , Military Personnel , Naval Medicine , Reaction Time , Tibial Nerve/physiopathology , United KingdomABSTRACT
Decompression illness was formerly an occupational hazard confined to professional divers and compressed-air workers. With the increasing popularity of recreational diving it has come to involve a wider cross-section of the population. Furthermore, the proportion of cases presenting with the more serious manifestations of the disease appears to be rising.
Subject(s)
Decompression Sickness/physiopathology , Decompression Sickness/classification , Decompression Sickness/therapy , Emergency Medical Services , Humans , Hyperbaric Oxygenation , Physical Phenomena , Physics , Referral and Consultation , Terminology as Topic , United KingdomABSTRACT
A case of neurapraxia of the infraorbital nerve occurring as a result of maxillary sinus barotrauma in a diver is presented. Existing reports of a similar nature are reviewed and the pathogenesis of cranial nerve involvement in barotrauma is discussed. Guidelines for treatment are suggested.
Subject(s)
Barotrauma , Maxillary Sinus/injuries , Trigeminal Nerve Injuries , Adult , Diving/injuries , Humans , MaleABSTRACT
The period from 1 January 1980 to 31 December 1989 produced a total of 244 training and operational diving accident reports involving Royal Navy and Royal Marines personnel. Because the incidence figures fluctuated widely year by year, a clear trend over the decade failed to emerge. However, the incidence of Type II decompression sickness, as a percentage of total decompression sickness, was greater in the second half of the decade than in the first, a trend similar to, although more moderate than, recent experience of dysbaric illness amongst sport divers. Student divers were disproportionately highly represented in the statistics, particularly with regard to pulmonary barotrauma and near-drowning.
