Acute spinal cord injury caused by high-voltage electrical burn requiring a multidisciplinary approach in a resource-limited setting: A case report

Tissue damage from an electrical burn could result from either direct electrical current and/or its conversion from electric to thermal energy. Although loss of consciousness, altered mentation, and peripheral neuropathy are the common neurologic sequelae of electrical burns, spinal cord injury can also be the only neurological complication of high-voltage electrical burn injuries. In this case report we present scalp soft tissue defect and acute spinal cord injury following high voltage electrical burn in a 35 years old male patient. We aim to emphasize the importance of multidisciplinary management in improving patient outcomes. A 35-year-old soldier experienced a high-voltage power live burn injury to the right frontal area of the head. Eight hours after the injury, he developed bilateral lower-extremity weakness and a tingling sensation. Basic investigations like CBC, renal function test, and ECG readings were normal. Both brain CT and spinal MRI studies reveal normal. Concomitant with wound management, physiotherapy was initiated, and he had significant improvement in his weakness by the end of the third week. Despite accounting for less than 4% of burn case, electrical burn have special concerns including the potential for cardiac arrhythmias and compartment syndromes with concurrent rhabdomyolysis. Other types of burns include flame burn and scald burn. High-voltage electrical burn injuries are serious problems causing variable degrees and types of neurologic impairments. Acute spinal cord injuries are among the less commonly reported problems. Given the limited effective treatment options for neurologic complications, appropriate preventive measures, multidisciplinary management, and long-term neurologic follow-up are important. • High-voltage electrical burns carry high morbidity and mortality. It also has higher risk of neurological involvement. • Electrical burns may harm the nervous system via heat, shock, or vessel injury. • Spinal cord injuries account for less than 6% of neurological problems from electrical burns. • In resource-limited areas, managing such cases is hard due to lack of facilities. • Early ICU care and coordinated management of complications improve patient outcomes.