Neurological Injuries After an Electric Shock or Lightning Stroke - An Overview

Introduction

Injuries that are caused due to electrical shock and lightning strikes affect various systems in the body. However, the most commonly occurring effect includes neurological (nerve-related) complications. This is because the ability to resist the electric current flow is less in nerve tissues when compared to other body tissues. The injuries caused due to electric currents and lightning are different from each other. Low-voltage electric shock may lead to delayed neurological complications in some persons.

What Is Electric Shock Injury?

An electrical shock injury is damage that occurs to the internal organs or skin when an individual comes into direct contact with an electrical current. As the human body is a good conductor of electricity, an electric current pass easily through the human body. Hence electrical shock injuries can cause serious complications. In some cases, electrical shock injuries may look minor, but they cause serious damage to internal organs like the heart and brain.

What Is Lightning Stroke Injury?

Injuries that occur when a flash of lightning hits the human body are known as lightning stroke injuries. If a person gets directly struck by lightning, one part of the current moves over the skin surface, causing burns, whereas another amount of the current moves through the body, thereby causing complications in internal organs like the heart and brain.

What Are the Complications of Electric Shock or Lightning Stroke?

The complications that are commonly seen in persons who are affected by an electric shock or lightning stroke are as follows:

• Irregular heartbeat or heart attack.

• Eye injuries.

• Difficulty in speaking.

• Increased blood pressure.

• The color of the feet turns blue.

• Burns on the skin.

• Reduced oxygen content in the blood leads to difficulty in breathing.

• Sharp pain in the ear followed by reduced ability to hear.

• Muscle aches.

What Are the Neurological Complications of Electric Shock or Lightning Stroke?

• Abnormal tingling or pricking sensation in the body due to the pressure exerted on peripheral nerves (nerves outside the brain and spinal cord).

• Vertigo (dizziness and feeling of spinning).

• Seizures (sudden and uncontrolled disturbances in the brain).

• Loss of control over regular body movements like walking.

• Brain hemorrhage (bleeding within the brain or between the brain and skull).

• Temporary or permanent paralysis of legs.

• Inability to remember the things that happened before the accident.

• The confused state of mind.

• Issues with coordination and balance.

• Difficulty focusing on a particular task.

• Change in personality with sudden mood swings.

• Loss of consciousness.

• Coma.

• Stroke (decreased blood supply to the brain resulting in lack of oxygen to the brain tissues).

How to Diagnose Electric Shock or Lightning Stroke Injuries?

There is no specific test to diagnose electric shock or lightning stroke injuries. All the patients who have undergone electric shock or lightning stroke accidents do not require to undergo tests or laboratory procedures. However, depending on the injury's severity and the patient's condition, the doctor may advise certain tests. They are as follows:

• Physical Examination: The doctor performs a detailed physical examination of the patient to find out burns and other external injuries which can be seen on the body. The doctor also checks if the patient has any abnormalities in walking style and behavior. The doctor makes a detailed investigation to find out if the patient is experiencing memory-related problems.

• Computed Tomography (CT) Scan: Computed tomography is an imaging test in which a computer and a combination of X-rays are used to produce detailed images of different organs of the body. Images obtained from computed tomography contain more information than standard X-rays. In case of electric shock or lightning stroke injuries, patients with burns on the head, loss of consciousness, and other nerve-related abnormalities are advised to take a CT scan. Computed tomography of the head and brain helps to find out head injuries and any abnormalities of the brain.

• Single Photon Emission Computed Tomography (SPECT) Scan: Single photon emission computed tomography scan is an imaging test in which a radioactive substance and a camera are used to obtain three-dimensional pictures of different organs and bones present in the body. The SPECT scan of the brain gives detailed information about the blood flow inside the brain. SPECT scan taken in persons affected by electric shock or lightning stroke helps to detect the regions of the brain with altered blood flow and areas of seizure activity in the brain.

• Magnetic Resonance Imaging (MRI): Magnetic resonance imaging is an imaging test in which large magnets, a computer, and radio waves are used to produce detailed images of different organs of the body. MRI of the brain in patients affected by electric shock or lightning stroke helps to detect brain abnormalities that have been caused due to head injuries.

• Electrocardiogram (ECG) And Echocardiogram: Electrocardiogram (ECG) is a painless test that is used to detect and record electrical signals of the heart. An echocardiogram is a test used to obtain pictures of the heart using sound waves. An echocardiogram helps the doctor examine the heart's heartbeat and blood-pumping activity. High-risk patients affected by electric shock or lightning stroke who have chest pain, breathlessness, and feeling of suffocation are usually advised for an echocardiogram and ECG.

How to Treat Electric Shock or Lightning Stroke Injuries?

As most of the patients affected by electric shock or lightning stroke injuries have multisystem involvement consisting of nerve-related complications, cardiac problems, burns, and trauma, a combination of life-supporting measures is often needed. The commonly employed treatment options are as follows:

• Patients who are at risk of cardiac arrest are made to undergo methods for airway control and chest compressions.

• Fluid resuscitation, which is the process of administering fluids into the body of a person to compensate for the lost fluid during electric shock, lightning stroke, or burn injuries is done. A fluid replacement can be done in minor cases by making the patient drink the fluids. In severe cases, fluid replacement is done intravenously.

• Reducing or eliminating all types of spine movements of the patient.

• The burn wounds are treated by cleaning and getting rid of the infected tissue and foreign materials. The burned areas are covered using a clean cloth or sterile gauze bandage. The body parts exposed to burning injuries are treated with early skin coverage to protect the underlying vital body parts.

• Fasciotomy: It is a surgical procedure in which the thin layer covering muscles, nerves, or blood vessels is cut to relieve the pressure exerted on muscles and nerves, which might lead to the destruction of muscles and nerves. This is done in patients with burn injuries affecting a large part of the body tissue.

• Medications for pain relief and nutritional support are given to the patient.

• Medicines to treat mood disorders and neuropsychological counseling are indicated in some patients.

Conclusion:

Even though severe risk factors are associated with electric shock and lightning stroke accidents, patients who undergo immediate treatment show a speedy recovery. Hence following basic measures like maintaining a proper airway and fluid replacement can save the patient from severe complications. Getting the first aid at the right time, followed by a proper treatment plan advised by a doctor, helps the patient to overcome the injuries and lead a normal life.