Paraplegia Following Decompression Sickness (Caisson Disease): A Journey to Near-Complete Recovery

Decompression sickness (DCS), also known as "Caisson disease," is a potentially life-threatening condition caused by the formation of inert gas bubbles during rapid decompression, most commonly affecting deepsea divers.Neurological involvement, particularly spinal cord injury leading to paraplegia, represents one of the most severe manifestations.We report the case of a 44-year-old Filipino male professional diver who developed acute paraplegia following a routine dive.Despite adherence to decompression protocols, he experienced sudden-onset bilateral lower limb weakness during ascent.Initial management included oxygen therapy followed by hyperbaric oxygen therapy, after which he was referred for intensive multidisciplinary rehabilitation within a few days.At presentation, the patient exhibited significant motor weakness with Medical Research Council grading of 2/5 in the left lower limb and 3/5 in the right lower limb, sensory loss below the T8 level, impaired bladder and bowel control, and complete dependence for mobility.Over a period of approximately three months of structured physiotherapy, including conventional therapy, roboticassisted rehabilitation, neuromuscular stimulation, and gait training, he demonstrated remarkable functional recovery.Muscle strength improved to 4/5, with restoration of independent ambulation, improved sensory function, and regained bladder control.This case highlights the importance of early recognition, prompt hyperbaric therapy, and intensive rehabilitation in achieving near-complete recovery following severe neurological DCS.