PARAPARESIS FOLLOWING PERIPHERAL AND CENTRAL NERVOUS SYSTEM LESIONS AFTER A LIGHTNING STRIKE – A CASE REPORT

JOURNAL OF REHABILITATION MEDICINE, 2025 · DOI: 10.2340/jrm-cc.v8.42545 · Published: April 1, 2025

Neurology Rehabilitation Research Methodology & Design

Simple Explanation

Lightning strikes, often seen as rare events, affect about 240,000 people worldwide each year, with many surviving. However, they can lead to serious injuries, especially to the nervous system. This article discusses the case of a 29-year-old gardener who was struck by lightning, resulting in weakness of the lower limbs. The patient experienced damage to both components of the nervous systems, presenting a rare combination of injuries. The results from imaging and neurological assessments provide valuable insights into the mechanisms of injury, which can inform treatment strategies and improve patient care. By enhancing our understanding of these complex injuries, we could support better individuals affected by lightning strikes.

Study Duration

5 Months

Participants

A 29-year-old male

Evidence Level

Level 4, Case Report

Key Findings

1
Spinal cord imaging showed hyperintensities with a quadrifocal white matter involvement.
2
Neurophysiological study revealed peripheral motor impairment.
3
This case documents paraparesis resulting from both central and peripheral nervous system damage following a lightning strike.

Research Summary

This case underscores the complex nature of injuries from lightning strikes, particularly their neurological consequences, highlighting both SCI and peripheral nerve disorder. Our findings support direct nerve damage as a contributing mechanism to SCI and provide the first documented case of lesion regression following a lightning strike. This case highlights the importance of conducting prompt MRI evaluations following a lightning strike, especially when neurological symptoms are present, as these can provide critical insight into the nature of the injury.

Practical Implications

Improved Clinical Management

Findings may help in refining clinical management strategies for lightning strike victims, including early MRI evaluations.

Enhanced Patient Education

Findings can be used to improve patient education about the potential neurological consequences of lightning strikes.

Understanding Nerve Damage

Unique spinal cord imaging results and neurophysiological studies contribute to the understanding of nerve damage mechanisms following lightning strikes.

Study Limitations

1
Relatively short follow-up period.
2
Challenge in delineating symptoms of peripheral nerve lesions due to concurrent SCI.
3
Determining the exact mechanism of lightning injury.

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