Transient Paraplegia After Electrocution: A Case Report

Thursday, November 16, 2023

Primary Author(s)

Aniroodh T. Reddy, MD

Resident Physician
Nassau University Medical Center PM&R Program
east meadow, New York

Co-Author(s)

Diane N. Moya, DO

Resident Physician
Nassau University Medical Center PM&R Program
East Meadow, New York
Kanwardeep Singh, MD

Resident Physician
Nassau University Medical Center PM&R Program
East Meadow, New York
Jack Leal, DO

Physical Medicine and Rehabilitation Resident
Nassau University Medical Center PM&R Program
New Hyde Park, New York
Edwin David, MD

Resident physician
Nassau University Medical Center PM&R Program
East meadow, New York
WG

Walter Gaudino, MD, PT

Attending Physician
NUMC
East Meadow, New York

Case Diagnosis: A 68-year-old male was electrocuted and presented with transient tetraplegia that rapidly improved.

Case Description or Program Description: A 68-year-old male electrician was electrocuted with 110 volts to the back of the head by livewire while holding a metal pole. The patient was found to be bradycardic and normotensive in the emergency department. The patient was noted to have a loss of sensation and motor function below the level of the clavicles. An emergent MRI showed moderate right foraminal stenosis at C3-4 and mild-moderate central canal stenosis at C3-6. Neurosurgery recommended a cervical collar and decadron therapy. On the first day after admission, the patient was noted to have some sensation in the upper extremities and lower torso. On the second day after electrocution, the patient regained some minor strength in the lower extremities with intact sensation in all four extremities. By the third day after electrocution, the patient regained full function of the upper extremities and only had residual weakness in the left lower extremity. By the fourth day after electrocution, the patient was able to ambulate and complete stairs independently.

Setting: Tertiary care center

Assessment/Results: The patient regained full function of his lower extremities, completed 12 stairs with no assistance, and was discharged home four days after electrocution.

Discussion (relevance): This case represents a very unique case of transient tetraplegia following electrocution. There have been rare previous case reports involving high-voltage electrocution causing transient paralysis. However, these case reports have been associated with either acute or delayed myelopathy on imaging or less significant neurologic symptoms. This case is unique because the patient’s tetraplegia was not associated with cervical myelopathy.

Conclusions: To our knowledge, this is the first known case report of transient tetraplegia following high-voltage electrocution that was not associated with myelopathy.