Disclosures: Mark E. Sederberg, DO: Nothing to disclose

Case Description: A 34-year-old female received an electrical shock while unplugging a disco ball from an outlet. Within 48 hours of injury, she developed a constant flexion of her left 3rd to 5th digits. The dystonic posturing caused pain to her forearm, and her fingernails were irritating her palm. On exam, she could not volitionally extend her fingers. She also had decreased sensation to the palmar aspect of digits 3-5 on the ipsilateral hand and medial distal forearm. Allodynia was present in her whole left hand. Neurological exam was otherwise normal. Electrodiagnostic studies confirmed strong dystonic muscle activity in the flexor digitorum profundus and the flexor digitorum superficialis. Previous treatments with diazepam, ibuprofen, and acetaminophen were without significant relief of the spasm and pain. Baclofen provided some relief at low doses, but she was unable to tolerate higher doses due to lethargy. She received chemodenervation with onabotulinumtoxinA under EMG guidance to the left flexor digitorum superficialis (75 units) and left flexor digitorum profundus (75 units).

Setting: Outpatient clinic at a tertiary care center

Patient: A 34-year-old female with peripherally-induced dystonia from low-voltage electrical shock

Assessment/Results: At 4 weeks post-injection, she reported a 60% reduction in pain from 6/10 to 2/10, and a subjective improvement in muscle tone.

Discussion: Peripherally-induced dystonia is a rare entity, with only 3 prior reports of dystonia induced by electrical shock. This is the first reported case caused by low-voltage shock, in which the patient was not described to have been thrown a distance by the electrical injury.

Conclusion: Peripherally-induced dystonia may occur after even low-voltage electrical shock. The patient was treated successfully with onabotulinumtoxinA.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/peripherally-induced-dystonia-after-low-voltage-electrical-shock-a-case-report/