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Efficient Differentiation of Postganglionic Sympathetic Neurons using Human Pluripotent Stem Cells under Feeder-free and Chemically Defined Culture Conditions
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Paroxysmal Sympathetic Hyperactivity: An Old but Unrecognized Condition.

Filipa Brás Monteiro1, Ricardo Castro Fonseca1, Rita Mendes1

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European Journal of Case Reports in Internal Medicine
|February 14, 2019
PubMed
Summary

Paroxysmal sympathetic hyperactivity (PSH) is a condition causing excessive sympathetic discharge in traumatic brain injury (TBI) survivors. Early recognition and treatment of PSH are vital to prevent prolonged hospital stays and improve patient recovery.

Keywords:
Paroxysmal sympathetic hyperactivity (PSH)beta-blockerfevertraumatic brain injury (TBI)

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Area of Science:

  • Neurology
  • Critical Care Medicine

Background:

  • Traumatic brain injury (TBI) survivors may exhibit symptoms of excessive sympathetic discharge.
  • Paroxysmal sympathetic hyperactivity (PSH) is a recently defined syndrome characterized by these symptoms.
  • Delayed diagnosis of PSH in TBI patients leads to increased healthcare costs and prolonged recovery.

Purpose of the Study:

  • To highlight the impact of unrecognized paroxysmal sympathetic hyperactivity on patient rehabilitation.
  • To emphasize the importance of considering PSH in TBI patients presenting with specific clinical features.

Main Methods:

  • This is a case report detailing a TBI patient's experience.
  • The report focuses on how the patient's rehabilitation was affected by a failure to diagnose PSH.
  • Clinical characteristics suggestive of PSH were present in the patient.

Main Results:

  • The patient's rehabilitation program was negatively impacted due to the undiagnosed PSH.
  • Fever, a common sign in hospitalized patients, can be a manifestation of PSH in TBI.
  • Failure to identify PSH contributed to delays in appropriate management.

Conclusions:

  • Paroxysmal sympathetic hyperactivity (PSH) should be considered in traumatic brain injury (TBI) patients, especially those with fever.
  • Prompt diagnosis and management of PSH are crucial for optimizing patient recovery.
  • Undiagnosed PSH can lead to significant adverse outcomes and prolonged hospitalizations.