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Case Reports
. 2025 Apr 1:8:42545.
doi: 10.2340/jrm-cc.v8.42545. eCollection 2025.

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

Zoé Moyaux  1   2 , Maria Ciravegna Fonseca De Melo Bandeira  3 , Idil Gunes Tatar  4 , Gautier Randour  2 , Mathilde Massardier  2 , Vincent Van Pesch  3 , Thierry Lejeune  1   2
Affiliations
Case Reports

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

Zoé Moyaux et al. J Rehabil Med Clin Commun. .

Abstract

Objective: 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.

Design: A case report.

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

Methods: 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.

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

Conclusion: 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.

Keywords: case report; lightning injuries; peripheral nervous system diseases; spinal cord disease.

Plain language summary

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.

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Figures

Fig. 1
Fig. 1
Picture of the cutaneous lesion (A. torso, B. right foot, C. left ear, D. toes right foot, E. ankles, F. back).
Fig. 2
Fig. 2
International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examination on the admission in the rehabilitation department.
Fig. 3
Fig. 3
MRI imaging (A. First sagittal Short Tau Inversion Recovery (STIR), B. First magnetic resonance imaging (MRI) sagittal T2, C. First MRI axial T2, D. Second MRI sagittal STIR, E. second MRI sagittal T2).
See this image and copyright information in PMC

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