Lightning strike‑induced cauda equina syndrome: a case report

Area of Science:

• Neurology
• Neurosurgery
• Electromyography

Background:

• Peripheral nerve injuries from lightning strikes are infrequently documented.
• Cauda equina syndrome is a rare but severe neurological condition affecting the lower spinal cord.

Observation:

• A 27-year-old male experienced neurological deficits, including saddle region numbness and urinary urgency, after a lightning strike.
• Clinical examination revealed absent Achilles reflexes and paresthesia, while spinal MRI was unremarkable.

Findings:

• Electrophysiological studies confirmed cauda equina lesions involving bilateral L5, S1, and S2 myotomes.
• This case highlights a unique presentation of lightning-induced peripheral nerve injury.

Implications:

• Lightning-induced cauda equina syndrome is a rare neurological complication.
• Electromyography is essential for diagnosing peripheral nerve injuries in patients with neurological complaints after lightning exposure.
• Further studies are needed to establish the true incidence of such injuries.