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[Paroxysmal sympathetic hyperactivity].

Alba Corell1, Johan Ljungqvist2

  • 1med dr, ST-läkare, sektionen för klinisk neurovetenskap, institutionen för neurovetenskap och fysiologi, Göteborgs universitet, Sahlgrens-ka akademin; sektionen för neurokir-urgi, Neurosjukvården, Sahlgrenska universitetssjukhuset, Göteborg.

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Summary
This summary is machine-generated.

Paroxysmal sympathetic hyperactivity (PSH), or autonomic storm, affects 8-10% of patients with traumatic brain injury. Increased awareness and diagnosis are crucial for managing this underrecognized neurological condition.

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Area of Science:

  • Neurology
  • Critical Care Medicine
  • Neuroscience

Background:

  • Paroxysmal sympathetic hyperactivity (PSH), also known as autonomic storm or dysautonomia, is a condition primarily observed in patients following traumatic brain injury (TBI).
  • PSH affects an estimated 8-10% of TBI patients and can also occur after other neurological insults like stroke, tumors, infections, or anoxic brain injury.
  • The condition is characterized by a distinct set of symptoms including tachycardia, tachypnea, hypertension, hyperthermia, hyperhidrosis, and increased muscle tonus.

Purpose of the Study:

  • To summarize the key features, diagnostic considerations, and management strategies for Paroxysmal Sympathetic Hyperactivity (PSH).
  • To highlight the importance of recognizing PSH in patients with neurological conditions.
  • To emphasize the likely underdiagnosis of PSH and the need for increased clinical awareness.

Main Methods:

  • Review of existing literature and clinical descriptions of Paroxysmal Sympathetic Hyperactivity (PSH).
  • Analysis of diagnostic criteria and established symptom profiles for PSH.
  • Summary of current pharmacological and non-pharmacological treatment approaches.

Main Results:

  • PSH presents with a consistent pattern of autonomic dysfunction: tachycardia, tachypnea, hypertension, hyperthermia, hyperhidrosis, and increased muscle tone.
  • Established diagnostic criteria aid in identifying PSH, necessitating the exclusion of other potential causes for the observed symptoms.
  • Treatment for PSH is typically multimodal, involving both pharmacological and non-pharmacological interventions.

Conclusions:

  • Paroxysmal Sympathetic Hyperactivity (PSH) is a significant, yet potentially underdiagnosed, complication following neurological injury, particularly TBI.
  • Accurate diagnosis requires careful exclusion of other conditions and adherence to established criteria.
  • Multimodal treatment strategies are essential for managing PSH, and increased clinical awareness is vital for improving patient outcomes.