Affiliations: [a] Department of Neurology, Deutsche Klinik für Diagnostik, Wiesbaden, Germany | [b] Lightning Data Center, St. Anthony Hospital, Denver, CO 80204, USA | Lightning Data Center, St. Anthony Hospital, 4231 W. 16th Avenue, Denver, CO 80204, USA. Tel.: +1 303 629 4258; Fax: +1 303 629 4438; E-mail: [email protected]
Correspondence:
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Address for correspondence: Professor Dr. Wolfgang H. Jost, Chief of the Department of Neurology, Deutsche Klinik für Diagnostik, Aukammallee 33, 65191 Wiesbaden, Germany. Fax: +49 611 577311; E-mail: [email protected]
Abstract: Autonomic nervous system (ANS) dysfunction is a serious complication of lightning and electrical trauma (L/ET). The ANS regulates the normal vegetative functioning of many organ systems. When ANS is compromised after lightning and electric trauma, patients are vulnerable to serious medical problems. Three conditions of ANS dysfunction of particular concern for L/ET patients are complex regional pain syndrome (CRPS), cardiovascular abnormalities, and keraunoparalysis (KP). The patient with CRPS presents with pain, hyperpathia, sweating, and edema hours to days after trauma. Neurorehabilitation is exceedingly important. A primary goal is to keep the affected extremity mobile and functional. Some patients benefit from sympathetic blockade. Cardiovascular abnormalities associated with lightning and electrical trauma can be life threatening. Care for these patients require a multidisciplinary team including a cardiologist. Keraunoparalysis is a frightening and distressing complication of lightning strikes. The syndrome consists of limb paralysis, sensory symptoms, pallor, coolness and absent pulses. Release of excessive catecholamines is said to be responsible for these findings. Fortunately, the condition is transient.
