Delayed reversible motor neuronopathy caused by electrical injury

Area of Science:

• Neurology
• Electrophysiology
• Neuroscience

Background:

• Electrical injuries can lead to central nervous system (CNS) complications and peripheral nerve disorders.
• Delayed neurological complications following electrical injury are infrequently documented.
• This report focuses on a rare instance of delayed, reversible motor neuronopathy attributed to low-voltage electrical shock.

Observation:

• A 22-year-old female experienced a 110-volt electrical shock, resulting in temporary quadriplegia.
• One month after initial recovery, she developed progressive weakness and numbness in her upper limbs.
• Neurological examinations, including nerve conduction studies and MRI, were largely unremarkable, but EMG indicated an anterior horn cell lesion.

Findings:

• Electromyography (EMG) revealed mild denervation and signs suggestive of an anterior horn cell lesion in the upper limbs.
• Despite initial recovery from quadriplegia, a delayed onset of motor neuronopathy manifested as upper limb weakness.
• The patient demonstrated significant recovery with rest and rehabilitation, regaining full muscle power within four months.

Implications:

• Low-voltage electrical currents can precipitate both acute neurological deficits and delayed-onset motor neuronopathy.
• The exact mechanism underlying the delayed neurological deterioration and subsequent recovery remains unclear, potentially involving factors similar to post-polio syndrome.
• Further research is warranted to elucidate the pathophysiology of delayed neurological complications after electrical injuries and to explore potential treatment strategies.