Severe hypokalemia as a cause of acute transient paraplegia following electrical shock

The Silent Threat of Hypokalemia after High Voltage Electrical Injuries: A Case Study and Review of the Literature

High-voltage electrical injuries, especially from lightning strikes, can cause life-threatening complications due to extreme temperature and voltage exposure. While burns and cardiac complications have been widely described, the documentation of metabolic imbalances, particularly hypokalemia, has not been as prevalent. This report focuses on a patient with profound transient hypokalemia following a lightning strike, alongside a review of three similar cases of transient hypokalemia from the literature. Our patient, a previously healthy young man, was struck by lightning and subsequently suffered transient hypokalemia with lower extremity sensory changes, which resolved after the normalization of serum potassium levels. While the exact underlying mechanisms of transient hypokalemia following high-voltage electrical injuries are unknown, we propose a multifactorial mechanism, which includes massive intracellular shifts of potassium due to elevated epinephrine levels and the prevention of potassium efflux through the electrical disruption of voltage-gated potassium channels. Our report underscores the importance of recognizing hypokalemia in patients with high-voltage electrical injuries and contributes to the understanding of the complex mechanisms involved. Further research is necessary to understand the connection between cellular changes induced by high-voltage exposure and their effects on metabolism, particularly in relation to hypokalemia.

Hypokalaemia with flaccid paralysis following high-voltage electrical injury in an adolescent patient

The authors present a case report of a previously healthy 15-year-old male who experienced global weakness in the presence of profound hypokalaemia following a high-voltage electrical arc injury. The clinical picture is discussed in the context of our evolving understanding of electrical injuries and potassium homeostasis.

Neurological manifestations of electrical trauma

Some degree of neurological impairment is often found in patients following electrical injury. A wide range of neurological impairments can occur including peripheral neuropathies, chronic pain syndromes, brain injury and rarely severe paralytic syndromes. Outcome is difficult to accurately predict. The symptoms can present immediately or be delayed in onset. They can also be temporary, permanent or get progressively worse with time. The neurological impairment resulting from the current often comprises a substantial proportion of the morbidity associated with such injuries. It is known that electrical current can cause nerve injury, however, the primary etiology of such damage is yet to be elucidated. An unusual case of transient paralysis after high voltage burn associated with severe hypokalemia provides unique insight into a potential mechanism for nerve injury following electrical trauma.