Paroxysmal sympathetic hyperactivity in neurological critical care

Area of Science:

• Neurocritical care
• Neurology
• Critical care medicine

Background:

• Paroxysmal sympathetic hyperactivity (PSH) is a clinical disorder often resulting from brain injuries like TBI and stroke.
• PSH manifests with episodes of hypertension, tachycardia, tachypnea, fever, and dystonic postures.
• This study focuses on the clinical profile and outcomes of PSH patients in a neurocritical care unit.

Purpose of the Study:

• To describe the clinical characteristics and outcomes of patients with Paroxysmal Sympathetic Hyperactivity (PSH).
• To investigate the causes and complications of PSH in a neurocritical care setting.
• To identify potential novel associations of PSH with specific neurological conditions.

Main Methods:

• A prospective observational study was conducted over a 6-month period.
• Patients admitted to a neurology critical care unit were screened for PSH.
• Clinical details and patient outcomes were systematically documented.

Main Results:

• PSH was identified in 6 patients (5 males, 1 female) with a mean age of 36.67 years.
• Leading causes included traumatic brain injury (2), stroke (2), Japanese encephalitis (1), and tuberculous meningitis (1).
• PSH was observed to prolong hospitalization and impede patient recovery.

Conclusions:

• PSH is an uncommon complication in neurocritical care settings.
• It significantly impacts patient recovery and prolongs hospital stays.
• The study identified previously undescribed associations between PSH and Japanese encephalitis and tuberculous meningitis, emphasizing the need to exclude mimicking conditions.