Paroxysmal sympathetic hyperactivity associated with posterior reversible encephalopathy syndrome

Area of Science:

• Neurology
• Critical Care Medicine

Background:

• Paroxysmal sympathetic hyperactivity (PSH) is characterized by episodes of autonomic dysfunction.
• Posterior reversible encephalopathy syndrome (PRES) involves vasogenic edema and neurological symptoms following brain injury.

Purpose of the Study:

• To report a case of PRES complicated by PSH.
• To highlight the importance of recognizing PSH in patients with acquired brain injuries.

Main Methods:

• Case report of a patient with PRES.
• Clinical observation of PSH symptoms including rigidity, hypertension, tachycardia, and diaphoresis.
• Treatment with clonidine.

Main Results:

• The patient initially presented with status epilepticus and PRES.
• PSH symptoms developed during hospitalization, triggered by stimuli.
• Clonidine treatment led to significant improvement in PSH symptoms.

Conclusions:

• PRES can be complicated by PSH.
• A high index of suspicion for PSH is crucial in patients with acquired diffuse brain injuries like PRES.
• Early diagnosis and management of PSH can improve patient outcomes.