CASE REPORTS Delayed Cervical Spinal Cord Injury After High Voltage Electrical Injury: A Case Report Gu ¨lten Erkı ˙n, MD,* Meltem Akinbı ˙ngo ¨l, MD,† Hilmi Uysal, MD,‡ Isik Keles, MD,§ Canan Aybay, MD,* Sumru O ¨ zel, MD* High voltage electrical injuries usually cause devastating consequences for patients, most of which result in permanent disability. Spinal cord injury (SCI) caused by high voltage elec- trical injury is uncommon in the literature. We present a 29-year-old male patient who was diagnosed as having delayed SCI after high voltage electrical injury. The patient developed muscle weakness in the lower extremities with the loss of pinprick sensation below the fifth cervical spinal segment, 2 days after the high voltage electrical injury. Magneticresonance imaging of the brain, cervical and thoracic spine was normal. Nerve conduction and needle elec- tromyography studies were normal, except for bilateral tibial and left median somatosensory- evoked potentials. The findings on initial examination and neurophysical investigation showed incomplete cervical SCI at the C5 level. He was able to walk with a pair of canes and bilateral ankle-foot orthosis at the end of the 2-month rehabilitation. Follow-up physi- cal and electrophysiological examination of the patient 15 months after injury showed fur- ther improvement. The patient was able to walk with a pair of canes without orthoses. Elec- trophysiological studies are useful instruments in the diagnosis and follow-up of these patients. Early rehabilitation is essential to obtain a favorable outcome in patients with SCI caused by high voltage electrical injury. (J Burn Care Res 2007;28:905–908) Electrical injuries still remain a major public health problem in many countries. The complications are usu- ally devastating and frequently lead to life-threatening consequences with poor outcomes. Electrical injuries are reported to constitute 21% of all burns, with higher complications, treatment costs, and longer pe- riod of hospitalization in our country. 1 High voltage electrical injuries cause clinical findings ranging be- tween uncomplicated skin burns and severe neuro- logical diseases with fatal consequences. The neuro- logical complications in association with electrical injuries are reported to develop in 40 to 75% of the patients, 2 involving the brain, spinal cord, or periph- eral nerves with immediate or delayed clinical presen- tations. 2–4 Spinal cord injury (SCI) caused by high voltage electrical injury is uncommon in the litera- ture. The reported incidence of SCI after high voltage electrical trauma ranges between 2 and 5%. 4 We re- port here a unique case of delayed SCI caused by high voltage electrical injury. CASE REPORT The 29-year-old male subject traveling in a truck bed grabbed a high voltage cable hanging down from a utility pole. He fell 2.5 m to the ground from the moving truck after contacting the 34,000 V of alter- nating current. He was unresponsive and suffered cardiopulmo- nary arrest. Cardiopulmonary resuscitation was initi- ated within 3 to 5 minutes after the accident, and after a short time, the patient recovered sinus rhythm, a normal blood pressure, and regained consciousness. The patient remained confused but not agitated for approximately 1 hour after resuscitation. After the cardiopulmonary resuscitation, the patient’s Glasgow From the *Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ministry of Health, Turkey; †Department of Physical Medicine and Rehabilitation, Acıbadem Hospital, I ˙ stanbul, Turkey; ‡Department of Neurology, Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ministry of Health, Turkey; and §Department of Physical Medicine and Rehabilitation, Kırıkkale University, Faculty of Medicine, Kırıkkale, Turkey. Address correspondence to Gu ¨lten Erkı ˙n, MD, Mektep sokak No: 16/3, 06600, Kurtulus/Ankara, Turkey. Copyright © 2007 by the American Burn Association. 1559-047X/2007 DOI: 10.1097/BCR.0b013e318159a3a1 905