Brachial Plexopathy Following an Electrocution Accident: A Case Report and Review of Literature

This report presents a case of a 41-year-old male who sustained an accidental electrocution while handling a bare electrical cable with his right index finger. The electrical current passed from the upper limb to the neck, resulting in severe neuralgia and paresis of the right brachial plexus. Electroneuromyography (ENMG) performed six weeks after the incident revealed involvement of the lower primary trunk of the right brachial plexus, characterized by absent sensory potentials in the ulnar and internal brachiocutaneous nerves and reduced motor potentials in the ulnar and median nerves. The patient exhibited decreased osteotendinous reflexes and motor weakness in the affected limb, accompanied by paroxysmal pain radiating from the shoulder to the wrist. Treatment comprised gabapentin for neuropathic pain, ketoprofen as an anti-inflammatory, and physiotherapy rehabilitation. After one month, the patient showed complete motor recovery and significant pain relief. Unfortunately, MRI of the brachial plexus was not performed due to financial constraints. This case underlines the rarity of unilateral brachial plexopathy following electrocution, a condition infrequently reported in medical literature, especially in the African context. The pathophysiological mechanisms include thermal injury, electroporation, and ischemic nerve damage. Early electrophysiological assessment and tailored rehabilitation are crucial to optimize neurological recovery and prevent chronic sequelae. The report highlights the need for increased awareness and specialized management of peripheral nerve injuries secondary to electrical accidents to improve functional outcomes.