Differential Diagnosis for Electrocution Injury with Limb Mobility Difficulty

• Single most likely diagnosis:
  • High Voltage Electrical Injury with associated neuropathy or muscle damage: This is the most direct consequence of coming into contact with a high voltage electric wire. The electrical current can cause direct damage to muscles and nerves, leading to difficulty in moving limbs.
• Other Likely diagnoses:
  • Rhabdomyolysis: The intense heat generated by the electrical current can cause muscle breakdown, leading to rhabdomyolysis, which can cause limb weakness among other symptoms.
  • Cardiac complications (e.g., arrhythmias, cardiac arrest): Electrical shock can disrupt heart function, potentially leading to arrhythmias or even cardiac arrest, which might indirectly affect limb mobility due to decreased circulation.
  • Thermal burns: High voltage electrical injuries can also cause thermal burns, both at the entry and exit points of the current, which might lead to pain and difficulty moving the affected limbs.
• Do Not Miss diagnoses:
  • Spinal cord injury: Although less common, a fall or the force of the electrical shock could potentially cause a spinal cord injury, leading to neurological deficits including paralysis or weakness of limbs.
  • Compartment syndrome: This is a potentially deadly condition that can arise from increased pressure within a muscle compartment, often due to swelling after an injury. It can cause severe pain, limb weakness, and if not treated promptly, can lead to permanent damage.
• Rare diagnoses:
  • Cerebral vasospasm or stroke: In rare cases, the electrical shock could potentially cause a vascular event in the brain, leading to a stroke or cerebral vasospasm, which might result in limb weakness or paralysis.
  • Psychogenic paralysis: Although rare, the psychological trauma of being electrocuted could potentially lead to a conversion disorder, where the patient experiences paralysis or weakness without a clear neurological cause.