@article{ref1,
title="Lesions along the upper motor neuronal pathway with locked-in features after lightning strike and cardiac arrest: A case-review analysis",
journal="Brain injury",
year="2014",
author="Abdulla, Susanne and Conrad, Anton and Schwemm, Karl-Peter and Stienstra, Mark P. and Gorsselink, Edward L. and Dengler, Reinhard and Abdulla, Walied",
volume="28",
number="3",
pages="298-303",
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.<p /> <p>Language: en</p>",
language="en",
issn="0269-9052",
doi="10.3109/02699052.2013.860476",
url="http://dx.doi.org/10.3109/02699052.2013.860476"
}