High Voltage Electrical Injury Leading to a Delayed Onset Tetraplegia, with Recovery

Abstract

High voltage electrical injury can cause considerable damage to the central nervous system. Delayed spinal cord injury is uncommon, usually incomplete, and comprises predominantly motor fallout. The injury can be progressive, with only a few patients showing partial improvement. We present a case report of a 20-year-old male who had a delayed onset spinal cord injury after a high voltage electrical injury. The symptoms started several days postburn with an ascending paralysis, leading to tetraplegia. Gradual recovery became evident at 3 months after the accident, starting with his arms and later showing partial recovery of his lower limbs. The mechanisms of injury and pathophysiology to the spinal cord are poorly understood. Possible explanations for the delayed onset of neurologic complications are given. The exact reasons for the delayed, ascending paralysis and the mechanism of recovery still need further investigation.

Frontal lobe hemodynamics detected by functional near-infrared spectroscopy during head-up tilt table tests in patients with electrical burns

“…TBSA varied from person to person because the resistance of each body part is a significant factor in determining the degree of damage (Christensen et al, 1980 ). In the human body, the resistance of the nervous system to electric current is small, and thus, in patients with electrical burns, the nervous system may be more damaged than other organs because of its good electrical conductivity (Breugem et al, 1999 ).…”

Metabolic and Toxic Myelopathies

“…Spontaneous improvements are often seen several weeks after onset, but the final outcome is highly variable, ranging from severe disability to complete recovery. [37][38][39][40][41] MRI findings for this delayed myelopathy are variable; T2 hyperintensities in the cord may be seen, but MRI may also be normal. 41 Pathologic findings include spinal cord swelling, petechial hemorrhage, fragmentation of axons, and myelin degeneration.…”

“…41 Pathologic findings include spinal cord swelling, petechial hemorrhage, fragmentation of axons, and myelin degeneration. 39 The pathophysiology is poorly understood; hypotheses include necrosis from heat, alteration of proteins from an electrogenic effect, and small vessel vascular changes. 38,40 A primarily demyelinating but noninflammatory process has also been suggested.…”

Epileptic Seizure, Cataract, and Tongue Atrophy during the 8 Years after Electrical Brain Injury

“…Delayed neurologic disorders include basal ganglia disorders (1,8), and spinal cord injury with and without recovery (4,5,10,12). Spinal cord injury is by far the most common of the permanent as well as transient complications, and it resembles either progressive muscular atrophy or motor neuron disease (10,12).…”