National Weather Service Taunton MA
110 PM EDT Wed Jun 22 2005

National lightning safety preparedness week

Part three - medical aspects of lightning

The United States averages 73 reported lightning deaths per year, which makes it the second largest storm related killer, exceeded only by flash floods. A lightning strike can result in cardiac arrest at the time of the injury, but some deaths can occur a few days later if the person is resuscitated but suffered irreversible brain damage. Because this May occur days later, the news story May not make the newspaper or other media outlets. Thus, there is an under reporting of injuries and deaths from lightning. The figures more realistically are about 100 deaths per year nationwide.

How do lightning injuries affect people? lightning tends to be a nervous system injury and May affect the brain and both autonomic and peripheral nervous systems. When the brain is affected, the person often has difficulty with short-Term memory, multi-Tasking, and can be irritable, easily distracted, and have a personality change. Survivors initially May complain of intense headaches, ringing in the ears, dizziness, nausea, vomiting, or other post-Concussion types of symptoms. Irregular sleep patterns May occur. Seizure-Like activity May occur weeks to months after the injury.

People who wake up after the injury often do not have the ability to express what is wrong with them and May become embarrassed when they cannot carry on a conversation. As a result they May isolate themselves and become easy to anger. Depression becomes a big problem. Survivors often become exhausted after only a few hours of work and May not be able to complete all required job tasks.

Another common, often delayed, problem for some survivors is intense pain. The pain May not be from headaches but in the back, perhaps from compression and disc injury from the intense muscle contractions which May throw a person several yards at the time of the injury. The pain May also occur in an extremity, as nerves begin to slowly regenerate. Decreased libido and impotence often are reported.

Anatomic testing, such as an x-Ray, CT scan, mri, or blood test often show up as normal. Sometimes functional tests ordered are testing the wrong thing. An electromyogram, or emg, measures only the motor fibers, which are seldom affected by lightning injury. smaller pain carrying nerve fibers are not tested by emg. Thus a normal emg result can mean little for someone with pain. Likewise, the standard eeg primarily measures surface readings of the brain and misses seizure activity in several deeper regions.

More useful is a functional test of how a person/S brain is working, neurocognitive or neuropsychological testing. These tests are administered by a neuropsychologist familiar with literature in this area, not by a psychiatrist. These are pen and paper tests lasting 6 to 8 hours and test memory, iq, organizational ability, etc. Lightning strike survivors usually have a characteristic pattern of deficits.

Help does exist for lightning strike survivors and physicians alike. For more information on the web, go to www.Lightning-Strike.Org or call 1-910-346-4708.

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