Delayed Spinal Cord Injury after Electrical Burn of the Head in Khon Kaen Hospital: Case Report

Main Article Content

Phonnapas Sukprasert

Abstract

Background and Objective: High-voltage electrical burn associated delayed spinal cord injury is a very low incidence with only few citations and reports. Although the sequelae is not a lift-threatening complication but can be devastating and the morbidity is high. In case with presentation is delayed for several days to weeks after the initial injury, recovery is not the rule. Clinical follow up with aggressive rehabilitation is essential for a successful of recovery. This study aimed to study clinical onset, pattern of neurological symptom and to study the recovery pattern in high voltage electrical injury leading to delayed spinal cord complication.


Materials and Method: Report the case of 18-year-old Thai man who experienced a high-voltage electrical injury of the head resulting in clinical myelopathy with quadriparesis in ascending pattern.


Results: An 18-year-old Thai man sustained a high-voltage-electrical injury to his head and was unconscious at the scene. He had burns to his head, left shoulder, left arm and both feet. Initially, he had no limb weakness. On the 7th day after injury, he was observed to move his legs less than his arms. Ct scan and MRI spine showed no pathology to describe the weakness. He received multiple skin graft and scalp rotational flap to coverage the burn wound and provide constant daily rehabilitation of all four limbs in 64 days in hospital. After neurological follow up at 8 months after the initial injury, motor power of the upper extremities are fully recovery (motor power gr V) and the lower extremities are improve (motor power grade II to grade III).


Conclusion: High-voltage electrical injuries are a serious problem with potential for both immediate and delayed spinal cord sequelae. Multidisciplinary management with long term follow up is required.

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How to Cite
1.
Sukprasert P. Delayed Spinal Cord Injury after Electrical Burn of the Head in Khon Kaen Hospital: Case Report. SRIMEDJ [Internet]. 2021 Aug. 20 [cited 2023 Jan. 27];36(4):495-500. Available from: https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/251843
Section
Case report

References

1. Shih JG, Shahrokhi S, Jeschke MG. Review of adult electrical burn injury outcomes worldwide: an analysis of low-voltage vs high-voltage electrical injury. J Burn Care Res 2017; 38: e293-298.
2. Ko SH, Chun W, Kim HC, Delayed spinal cord injury following electrical burns: a 7-year experience. Burn 2004; 30: 691-695.
3. Grube BJ, Heimbach DM, Engraw LH, Copass MK. Neurologic consequences of electrical burns. J Trauma 1990; 30: 254-258.
4. AlQasas T, Galet C, Wibbenmeyer L. Delayed spinal cord injury from electrical burns: Two cases. J Burn Care Res 2021; 42(3): 560-563.
5. Levine NS, Atkins A, McKeel DW Jr, Peck SD, Pruitt BA Jr. Spinal cord injury following electrical accidents: case report. J Trauma 1975; 15: 459-463.
6. Sharma SR, Hussain M, Hibong H. Cervical Myelopathy after high-voltage electrical burn of the head: report of an unusual case. Annals of Indian Academy of Neurology:vol21 2018
7. Silversides J. The neurological sequelae of electrical injury. Can Med Assoc J 1964; 91: 195–204.
8. Varghese G, Mani MM, Redford JB. Spinal cord injuries following electrical accidents. Paraplegia 1986; 24: 159–166.
9. Arévalo JM, Lorente JA, Balseiro‑Gómez J. Spinal cord injury after electrical trauma treated in a burn unit. Burns 1999; 25: 449‑452.
10. Johansen CK, Welker KM, Lindell EP, Petty GW. Cerebral corticospinal tract injury resulting from high‑voltage electrical shock. AJNR Am J Neuroradiol 2008; 29: 1142‑1143.