title: Central hyperadrenergic state after lightning strike.
abstract: OBJECTIVE
  To describe and review autonomic complications of lightning strike.
  
  
  METHODS
  Case report and laboratory data including autonomic function tests in a subject who was struck by lightning.
  
  
  RESULTS
  A 24-year-old man was struck by lightning. Following that, he developed dysautonomia, with persistent inappropriate sinus tachycardia and autonomic storms, as well as posttraumatic stress disorder (PTSD) and functional neurologic problems.
  
  
  CONCLUSIONS
  The combination of persistent sinus tachycardia and episodic exacerbations associated with hypertension, diaphoresis, and agitation was highly suggestive of a central hyperadrenergic state with superimposed autonomic storms. Whether the additional PTSD and functional neurologic deficits were due to a direct effect of the lightning strike on the central nervous system or a secondary response is open to speculation.
authors.affiliation: Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Parsaik
authors.forename: J Eric
authors.initials: JE
authors.lastname: Ahlskog
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Singer
authors.forename: Russell
authors.initials: R
authors.lastname: Gelfman
authors.forename: Seth H
authors.initials: SH
authors.lastname: Sheldon
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Seime
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Craft
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Staab
authors.forename: Birgit
authors.initials: B
authors.lastname: Kantor
authors.forename: Phillip A
authors.initials: PA
authors.lastname: Low
mesh_terms: D000203:Activities of Daily Living; D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D001007:Anxiety / Q000209:etiology; D001145:Arrhythmias, Cardiac / Q000209:etiology; D001342:Autonomic Nervous System Diseases / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D002056:Burns / Q000209:etiology / Q000473:pathology; D019090:Case Management; D003000:Clonidine / Q000627:therapeutic use; D006801:Humans; D015168:Lightning Injuries / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D009460:Neurologic Examination; D010146:Pain / Q000209:etiology; D054969:Primary Dysautonomias / Q000209:etiology; D011595:Psychomotor Agitation / Q000209:etiology; D020127:Recovery of Function; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000503:physiopathology; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D000316:Adrenergic alpha-Agonists; D003000:Clonidine