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The autonomic dysfunction syndrome: aetiology and treatment
1Division of Neurosurgery, Duke University Medical Center, Durham, NC 27710.
British Journal of Neurosurgery
|January 1, 1988
Summary
Autonomic dysfunction syndrome (ADS) episodes, characterized by sympathetic discharge and extensor posturing, were effectively managed with morphine and bromocriptine. Bromocriptine showed both short-term and long-term benefits in controlling ADS symptoms.
Area of Science:
- Neuroscience
- Neurology
Background:
- Autonomic dysfunction syndrome (ADS) presents with sympathetic discharge and extensor posturing.
- ADS can be associated with severe closed head injury and acute hydrocephalus.
Observation:
- Morphine consistently halted ADS episodes in three patients.
- Dantrolene reduced extensor posturing severity but did not affect other ADS components.
- Bromocriptine demonstrated acute and long-term efficacy, partially correcting hyperthermia and diaphoresis.
Findings:
- Long-term bromocriptine completely controlled ADS in one patient and decreased episode frequency in another.
- The findings suggest a potential role for opiate and dopaminergic pathways in ADS.
- A common theme of brainstem release from higher control is proposed for ADS etiologies.
Implications:
- These results highlight potential therapeutic targets for autonomic dysfunction syndrome.
- Understanding the neurochemical pathways involved could lead to novel treatment strategies.
- Further research into opiate and dopaminergic modulation may benefit patients with severe head injury and hydrocephalus.