Hello doctor,
My partner got an electric shock to his right arm a year ago. Ever since then, he has felt like he is constantly shocked, and he has been unable to move his arm properly. He is on 750 mg of Lyrica a day to control the shock-like feeling and pain. However, the hand movement has not returned. He has tried physiotherapy and hydrotherapy for seven months with no results. He now has severe muscle wasting of the right arm, particularly the shoulder. He had nerve conduction studies and an EMG performed by a general neurologist, two months ago. The NCS of the wrist showed unusual results, no numerical figure could be given, and instead, only pictures of the F-waves jumping around was shown. The EMG showed acute, chronic partial denervation in some muscles of the upper trunk, serratus anterior and rhomboids were incompletely studied as no results were able to be provided. The neurologist told us that the results were complex and unusual. He said that he could not help, and he did not know where to go from here. I am confused by what all this means. We do not know where to go from here. Could you please provide some insight or direction? He has not been diagnosed with anything yet. Thank you.
Hi,
Welcome to icliniq.com.
- Cases of motor neuron disease are seen after electric shocks. Most likely, your partner is experiencing wasting of muscles due to motor neuron disease post the electric shock.
- A motor neuron (or motoneuron) is a nerve cell, which directly or indirectly controls the effector organs, mainly muscles, and glands. The hands are frequent sites of contact in electrical accidents and when the current travels from one hand to the other, spinal cord damage with radiculopathy occurs.
- Radiculopathy is caused by compression or irritation of the nerves. This constant irritation of nerves can cause repeated electric shock-like sensation in the body.
- Spinal cord stimulation test should be done. When an electric current passes from limb to limb, injury to the spinal cord may induce the syndromes of progressive muscular atrophy, amyotrophic lateral sclerosis or transverse myelitis.
- The current passing from one hand to the other typically affects the fourth to eighth cervical spinal cord segments, and wasting of muscle groups supplied by the upper segments follows after a latent period, which varies from a few days to several months. The wasting is usually in the electrocuted limb.
- The mechanism by which electrical current causes neurological injury remote from the site of contact is not clear. Nervous tissue offers the least resistance to the passage of electricity from an extremity and pathological studies in such cases have demonstrated that, when damage occurs in the spinal cord, there is the preferential destruction of the anterior horn cells and less severe degeneration in the spinal tracts.
- An increase in blood pressure during tetanic muscle contraction has been told as a cause of rupture of small spinal vessels with associated ischaemic lesions in the cord.
- Doses of Pregabalin can be increased, and you should consult a neurologist at quaternary center like a medical school who are well versed in dealing with muscle wasting problems. Methylcobalamin can also be used.
Thanks.
For more information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician
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