Authors
Dr KK Mathew MD, Senior Consultant Physician, Pratheeksha, K.P. Road, Kayamkulam, Kerala
Abstract
Background: Horse bites are common and can lead to various injuries and infections, but neuropathy is not a commonly reported complication. This case report describes a unique instance of neuropathy following a horse bite.
Case Presentation: A 21-year-old male horse riding trainer presented with numbness and weakness in the medial aspect of his left palm and two fingers, two days after sustaining a horse bite. Examination revealed a superficial bite mark on the forearm, hypoesthesia, and mild weakness of the interossei and lumbrical muscles of the little and fourth fingers, suggesting ulnar nerve involvement. Routine investigations were normal.
Management: The patient received tetanus toxoid, local wound care with povidone-iodine, a 7-day course of cefpodoxime, and a regimen of vitamin B complex injections (mecobelamine, pyridoxine, nicotinamide) followed by oral supplements (methylcobalamine, alphalipoic acid, inositol, folic acid).
Outcome: The patient showed remarkable recovery. The wound healed, hypoesthesia resolved, and muscle strength returned completely within one month.
Discussion: The neuropathy was attributed to neuropraxia due to a pressure effect on the superficial part of the ulnar nerve, and it was demonstrably reversible. This case is notable as there are no previous reports of neuropathy complicating a horse bite. The administered treatment appeared to facilitate nerve recovery.
Conclusion: This case report highlights that neuropathy can be a rare, reversible complication of horse bites, likely due to neuropraxia. Awareness of this potential complication and appropriate supportive management can lead to a positive outcome.