Citation

Abdulla S, Conrad A, Schwemm KP, Stienstra MP, Gorsselink EL, Dengler R, Abdulla W. Brain Inj. 2014; 28(3): 298-303.

Affiliation

Department of Neurology, Otto von Guericke University Magdeburg , Magdeburg , Germany .

Copyright

(Copyright © 2014, Informa - Taylor and Francis Group)

DOI

10.3109/02699052.2013.860476

PMID

24354399

Abstract

OBJECTIVE: This study describes a case of lesions of the upper motor neuronal pathway with locked-in features after lightning strike and cardiac arrest. Design: A case-review analysis. METHODS: In a 29-year-old male who was hit by a lightning strike during farming activities, cardiopulmonary resuscitation was provided first by co-workers and continued with success by the medical rescue service. After conducting advanced life support under monitoring and therapeutic hypothermia, quadriplegia with facial diplegia was recognized. A review was undertaken detailing the clinical course. RESULTS: MR imaging presented signs consistent with hypoxia-induced damage and diffusion-weighted MR images revealed pronounced damages along the upper motor neuronal pathway. A reactive electroencephalogram pattern, sustained eye movement and the patient communicating via eye-blinking were interpreted as locked-in features. Two weeks after admission the patient was transferred to a neurological rehabilitation centre for further professional care. CONCLUSION: Direct damage of the upper motor neuron pathway due to the current of the lightning should be considered, albeit the relative contribution of hypoxia-induced damage cannot be separated.

Language: en