Background and Objective: High-voltage electrical burn associated delayed spinal cord injury is a very low incidence with only few citations and reports. Although the sequelae is not a lift-threatening complication but can be devastating and the morbidity is high. In case with presentation is delayed for several days to weeks after the initial injury, recovery is not the rule. Clinical follow up with aggressive rehabilitation is essential for a successful of recovery. This study aimed to study clinical onset, pattern of neurological symptom and to study the recovery pattern in high voltage electrical injury leading to delayed spinal cord complication.
Materials and Method: Report the case of 18-year-old Thai man who experienced a high-voltage electrical injury of the head resulting in clinical myelopathy with quadriparesis in ascending pattern.
Results: An 18-year-old Thai man sustained a high-voltage-electrical injury to his head and was unconscious at the scene. He had burns to his head, left shoulder, left arm and both feet. Initially, he had no limb weakness. On the 7th day after injury, he was observed to move his legs less than his arms. Ct scan and MRI spine showed no pathology to describe the weakness. He received multiple skin graft and scalp rotational flap to coverage the burn wound and provide constant daily rehabilitation of all four limbs in 64 days in hospital. After neurological follow up at 8 months after the initial injury, motor power of the upper extremities are fully recovery (motor power gr V) and the lower extremities are improve (motor power grade II to grade III).
Conclusion: High-voltage electrical injuries are a serious problem with potential for both immediate and delayed spinal cord sequelae. Multidisciplinary management with long term follow up is required.