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.