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

## TL;DR

A 29-year-old man developed lower limb weakness after a lightning strike, with both spinal cord and peripheral nerve damage revealed through imaging and neurological tests.

## Contribution

This case uniquely combines central and peripheral nervous system injuries from a lightning strike, with detailed imaging and neurophysiological findings.

## Key findings

- Spinal cord imaging showed hyperintensities with quadrifocal white matter involvement.
- Neurophysiological studies revealed peripheral motor impairment following the lightning strike.

## Abstract

To describe a case of paraparesis caused by both peripheral neuropathy and spinal cord injury following a lightning strike, highlighting imaging findings and neurophysiological results to improve understanding and management.

A case report.

A 29-year-old male without significant medical or surgical history, struck by lightning.

Neurological evaluation, imaging of the spinal cord, electromyography studies, and somatosensory evoked potential assessments were performed. Imaging findings and peripheral nerve evaluations were compared to the existing literature on lightning-related injuries.

Spinal cord imaging showed hyperintensities with a quadrifocal white matter involvement. Neurophysiological study revealed peripheral motor impairment.

This case documents paraparesis resulting from both central and peripheral nervous system damage following a lightning strike. Unique spinal cord imaging results and neurophysiological studies contribute to the understanding of nerve damage mechanisms. Given the increasing frequency of lightning strikes, these findings may help refining clinical management and patient education strategies.

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.