BIKE Syndrome: Biking Induced Kinetic Electroshock Syndrome

Introduction Patients with transient symptoms pose diagnostic dilemmas and may even be misdiagnosed with Functional Neurologic Disorder or somatization. We present a case of a patient with transient neuromuscular symptoms while cycling under a powerline. While this phenomenon is not reported in the clinical neurological or musculoskeletal literature, several online forums related to cycling describe bicyclists experiencing a similar sensation. To further investigate, we searched for all instances of microshocks occurring in cyclists using the following search term in Google: “electrical” AND (“bicycle” or “cycle”) AND (“microshock” or “shock”). Between 2006-2021, we identified 51 unique reports across 18 blog forums of cyclists describing microshocks in their groin or upper extremity while traversing under high voltage power lines (Table 1). In 11 of 18 forums, at least one of the posts described friends or family members characterizing the experiences as “impossible” or “hallucinations.” After an initial posting, additional shared experiences of microshock by other cyclists were offered in 12 forums. Seven forums speculated about shortand long-term health effects, while 13 forums specifically inquired about the etiology of the symptoms. Based on this review, electrical microshocks while cycling under high voltage powerlines may be more common than suspected a priori and are likely to be dismissed by close contacts or healthcare workers. These events commonly generate questions about health effects and potential causes for symptoms. Such questions are likely to be better addressed by healthcare providers or peerreviewed literature as compared to unverified blog postings by anonymous authors.1 This is the primary reason why we present this case.