Acute transient hemiparesis induced by lightning strike

According to data fromtheNationalOceanic and AtmosphericAdministration,
in the years from 1959 to 1994, lightning was responsible for
more than 3000 deaths and nearly 10,000 casualties. The most important
characteristic features of lightning injuries are multisystem involvement
and widely variable severity. Lightning strikes are primarily a neurologic
injury that affects all 3 components of the nervous system: central, autonomic,
and peripheral. Neurologic complications of lightning strikes vary
from transient benign symptoms to permanent disability. Many patients
experience a temporary paralysis called keraunoparalysis. Here we reported
a 22-year-old mountaineer man with complaining of left sided
hemiparesis after being hit by a lightning strike in the mountain
3 hours ago. There was no loss of consciousness at hitting time. On arrival
the patient was alert, awake and hemodynamically stable. In neurologic examination
cranial nerves were intact, left sided upper and lower extremity
muscle force was I/V with a combination of complete sensory loss, and
right-sided muscle force and sensory examination were normal. There is
not any evidence of significant vascular impairment in the affected extremities.
BrainMRI and CT scan and cervicalMRI were normal. During 2 days of
admission, with intravenous hydration, heparin 5000 unit SC q12hr and
physical therapy of the affected limbs, motor and sensory function improved
and was normal except mild paresthesia. He was discharged
1 day later for outpatient followupwhile vitamin B1 100mgorally was prescribed.
Paresthesia improved after 3 days without further sequels.