Bilateral Diffuse Leukoencephalopathy in an Electrocuted Patient Where the Brain Was Not in the Pathway of Conduction

Electrocution, damage caused by electric current passing through the body, is usually a serious event causing significant morbidity or even mortality. Graded damage is seldom encountered. According to Ohm's law, the current is directly proportional to the applied voltage and inversely proportional to the resistance of a circuit. Electric current is expected to travel through cells that have the least resistance. Therefore, cells that allow action potential to travel down their cell membrane are presumably the ones with the least resistance. Among these are neurons and cells within the cardiac conduction system. Within a neuron, the axon will conduct electricity better than the cell body. While there have been a few cerebral white matter lesions caused by electrocution described in the literature, the mechanism is not fully understood. We report a patient with bilateral symmetrical subcortical abnormality where the electric current entered one hand and exited through her legs without affecting the head directly. We reviewed the literature and we hope it will further our understanding of how electrocution affects the central nervous system and which groups and parts of neurons are more susceptible than others.