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Autonomic dysfunction in the neurological intensive care unit.

Max J Hilz1,2, Mao Liu3, Sankanika Roy3

  • 1Department of Neurology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany. max.hilz@uk-erlangen.de.

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|July 20, 2018
PubMed
Summary

Autonomic dysfunction is common in neuro-critical care, affecting organ function and prognosis. This overview highlights its impact in conditions like Guillain-Barré syndrome and brain injury.

Keywords:
Alcohol withdrawal syndromeAutonomic dysfunctionBotulismGuillain–Barré-syndromeNeurological intensive care medicineParoxysmal sympathetic hyperactivityTetanus

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Area of Science:

  • Neurology
  • Critical Care Medicine
  • Autonomic Nervous System

Background:

  • Autonomic dysfunction is a frequent complication in neuro-critical care patients.
  • It can compromise organ function and is associated with various neurological conditions.
  • Dysfunction involves sympathetic or parasympathetic hyper- or hypo-activity.

Purpose of the Study:

  • To provide a brief overview of autonomic dysfunction in selected neuro-intensive care diseases.
  • To highlight the clinical significance and potential life-threatening complications.

Main Methods:

  • Literature review and synthesis of existing data on autonomic dysfunction in specific neurological conditions.
  • Focus on Guillain-Barré syndrome, paroxysmal sympathetic hyperactivity, alcohol withdrawal, botulism, tetanus, and common neurological diseases.

Main Results:

  • Autonomic dysfunction in Guillain-Barré syndrome is linked to increased mortality and cardiovascular instability.
  • Paroxysmal sympathetic hyperactivity post-brain injury correlates with poorer prognosis.
  • Alcohol withdrawal, botulism, and tetanus present severe autonomic complications.

Conclusions:

  • Autonomic dysfunction significantly impacts patient outcomes in neuro-critical care.
  • Prompt recognition and management are crucial for mitigating life-threatening complications.
  • Neurological diseases like epilepsy and stroke are also associated with critical autonomic disturbances.