Neurologic and neurobehavioral effects of electric and lightning injuries

There are few studies of the effects of electric and lightning injuries (ELI) on the neurologic and neuropsychological status of injured patients. We reviewed records of fourteen patients with ELI injuries seen at our hospital (12 with high-voltage electric and two with lightning injury). Eight had cardiac arrest after injury, and 10 had neurologic complaints when first evaluated. Eight had normal neuroimaging results. Six had electroencephalograms; four showed abnormal results. Thirteen underwent neuropsychological testing. Twelve (92%) showed cognitive dysfunction including impairments in memory, attention, and affective disturbances (anxiety, depression, irritability, and poor frustration tolerance). Five of 12 (62%) had multiple physically aggressive outbursts, not present before the injury. Patients with cardiac arrest did not differ in neurologic psychologic testing from patients not sustaining cardiac arrest. Patients with ELI who had neurobehavioral symptoms had a coherent syndrome characterized by disturbances in cognition (attention and memory), mood (distress with prominent irritability), and behavior (aggressive outbursts). Serial neurologic and neuropsychological evaluations will aid in better defining the sequelae of ELI.