BMJ Case Reports 2009; doi:10.1136/bcr.06.2009.2008
  • Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

A lightning strike to the head causing a visual cortex defect with simple and complex visual hallucinations

  1. Ingo Kleiter1,
  2. Ralf Luerding1,
  3. Gerhard Diendorfer2,
  4. Helga Rek1,
  5. Ulrich Bogdahn1,
  6. Berthold Schalke1
  1. 1
    Department of Neurology, University of Regensburg, Regensburg, Germany
  2. 2
    Austrian Lightning Detection and Information System (ALDIS), Vienna, Austria
  1. I Kleiter, ingo.kleiter{at}
  • Published 7 July 2009


The case of a 23-year-old mountaineer who was hit by a lightning strike to the occiput causing a large central visual field defect and bilateral tympanic membrane ruptures is described. Owing to extreme agitation, the patient was sent into a drug-induced coma for 3 days. After extubation, she experienced simple and complex visual hallucinations for several days, but otherwise largely recovered. Neuropsychological tests revealed deficits in fast visual detection tasks and non-verbal learning and indicated a right temporal lobe dysfunction, consistent with a right temporal focus on electroencephalography. At 4 months after the accident, she developed a psychological reaction consisting of nightmares, with reappearance of the complex visual hallucinations and a depressive syndrome. Using the European Cooperation for Lightning Detection network, a meteorological system for lightning surveillance, the exact geographical location and nature of the lightning strike were retrospectively retraced


  • Competing interests: None.

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