Overlooked diagnoses in chronic pain: analysis of survivors of electric shock and lightning strike.

Objective: Patients who survive lightning strikes are rarely seen in clinical practice and patients with electrical injury are seen infrequently. This article reports the most commonly overlooked diagnoses so that physicians can improve their evaluations.

Methods: A total of 19 patients who survived a lightning strike and 53 patients who survived electrical shock had a partial or complete multidisciplinary evaluation at Mensana Clinic. A variety of diagnostic studies were ordered.

Results: In 19 lightning strike survivors, referring physicians did not mention 133 diagnoses, later established by Mensana Clinic. The overlooked diagnosis rate was 93%. In 53 patients who survived electrical shock, referring physicians did not mention 436 diagnoses, later established by Mensana Clinic. The overlooked diagnosis rate was 98.2%.

Conclusions: Patients who survive electric shock and lightning strikes are often misdiagnosed because they are infrequently seen in a medical practice.