4.69 CATATONIA OR PAROXYSMAL SYMPATHETIC HYPERACTIVITY? A CASE REPORT AND LITERATURE REVIEW OF CATATONIA IN TRAUMATIC BRAIN INJURY

2019 ◽  
Vol 58 (10) ◽  
pp. S243
Author(s):  
Hyowon Choi ◽  
Alexander Ambrosini ◽  
Odiraa C. Nwankwor ◽  
Alaukik Bhasin ◽  
Meghan Walsh-Farrell ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Case Report ◽  
Brain Injury ◽  
Literature Review ◽  
Sympathetic Hyperactivity ◽  
Paroxysmal Sympathetic Hyperactivity

scholarly journals Paroxysmal Sympathetic Hyperactivity in Patients Victims of Traumatic Brain Injury. Literature Review

2021 ◽  
Author(s):  
Gabriela Ferreira Kalkmann ◽  
Letícia Novak Crestani ◽  
Letícia Adrielle dos Santos ◽  
Carlos Umberto Pereira
Keyword(s):  
Traumatic Brain Injury ◽  
Nervous System ◽  
Brain Injury ◽  
Literature Review ◽  
Clinical Course ◽  
Sympathetic Hyperactivity ◽  
Paroxysmal Sympathetic Hyperactivity ◽  
Accurate Treatment ◽  
Acute Traumatic Brain Injury ◽  
External Stimuli

AbstractThe present literature review aims to present the physiology of paroxysmal sympathetic hyperactivity (PSH) as well as its clinical course, conceptualizing them, and establishing its diagnosis and treatment. Paroxysmal sympathetic hyperactivity is a rare syndrome, which often presents after an acute traumatic brain injury. Characterized by a hyperactivity of the sympathetic nervous system, when diagnosed in its pure form, its symptomatologic presentation is through tachycardia, tachypnea, hyperthermia, hypertension, dystonia, and sialorrhea. The treatment of PSH is basically pharmacological, using central nervous system suppressors; however, the nonmedication approach is closely associated with a reduction in external stimuli, such as visual and auditory stimuli. Mismanagement can lead to the development of serious cardiovascular and diencephalic complications, and the need for neurosurgeons and neurointensivists to know about PSH is evident in order to provide a fast and accurate treatment of this syndrome.

scholarly journals Cerebral fat embolization with paroxysmal sympathetic hyperactivity syndrome and septic shock at high altitude: a case report and literature review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Min Li ◽  
Gang Zhu ◽  
Hao Guo ◽  
Shun Nan Ge ◽  
Guo Dong Gao ◽  
...  
Keyword(s):  
Septic Shock ◽  
Differential Diagnosis ◽  
Case Report ◽  
Literature Review ◽  
High Altitude ◽  
Fat Embolism ◽  
Neurological Rehabilitation ◽  
Case Presentation ◽  
Sympathetic Hyperactivity ◽  
Paroxysmal Sympathetic Hyperactivity

AbstractBackgroundCerebral fat embolism (CFE) syndrome at high altitude was rare complicated with paroxysmal sympathetic hyperactivity (PSH) syndrome and septic shock. It is a challenge to differential diagnosis and treatment at high altitude.Case presentationThis case presents a CFE with PSH and septic shock of a 23-year-old man occurred at high altitude of 3800 m above sea level, transferred by airplane successfully and cured in the department of neurosurgery, Xi’an Tangdu Hospital.ConclusionsIt is key that CFE with PSH can be rapid diagnosed and treatment bundles of septic shock should be initiated as soon as possible. Early neurological rehabilitation played an important role for good outcome.

scholarly journals P88 Paroxysmal sympathetic storm and the role of beta-blockers in traumatic brain injury: a scoping review protocol

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Stéphane Nguembu ◽  
Marco Meloni ◽  
Geneviève Endalle ◽  
Hugues Dokponou ◽  
Olaoluwa Ezekiel Dada ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Length Of Stay ◽  
Glasgow Coma Scale ◽  
Scoping Review ◽  
Beta Blockers ◽  
Clinical Signs ◽  
Sympathetic Hyperactivity ◽  
Paroxysmal Sympathetic Hyperactivity

Abstract Introduction Most cases of paroxysmal sympathetic hyperactivity (PSH) result from traumatic brain injury (TBI). Little is known about its pathophysiology and treatment, and several neuroprotective drugs are used including beta-blockers. The aim of our study is to collate existing evidence of the role of beta-blockers in the treatment of PSH. Method We will search MEDLINE, Web of Science, EMBASE, Cochrane, and Google Scholar. The search terms used will cover the following terms: “paroxysmal sympathetic hyperactivity”, “traumatic brain injury” and “beta-blockers.”: No language or geographical restrictions will be applied. Two independent co-authors will screen the titles and abstracts of each article following predefined inclusion and exclusion criteria. If there is a conflict the two reviewers will find a consensus and if they cannot a third co-author will decide. Using a pre-designed and pre-piloted data extraction form, data from each included citation will be collected (authors identification, study type, TBI severity, type of beta-blockers used, dosage of the drug, clinical signs of PSH, Glasgow Coma Scale, Glasgow Outcome Scale, mortality, morbidity and length of stay). Simple descriptive data analyses will be performed and the results will be presented both in a narrative and tabular form. Results The effectiveness of beta-blockers in post-TBI PHS will be evaluated through clinical signs of PHS(increased heart rate, respiratory rate, temperature, blood pressure, and sweating), Glasgow Coma Scale, and Glasgow Outcome Scale. mortality, morbidity and length of stay. Conclusion At the end of this scoping review we will design a systematic review with metaanalysis if there are a reasonable number of studies otherwise we will design a randomized controlled trial.

Anesthetic management of a patient with traumatic brain injury in use of clopidogrel: case report and literature review

2014 ◽  
Vol 24 ◽  
Author(s):  
Daniella Semino Tavares ◽  
Patrícia Rodrigues da Silva ◽  
Luciana de Souza Cota Carvalho Laurentys
Keyword(s):  
Traumatic Brain Injury ◽  
Case Report ◽  
Brain Injury ◽  
Literature Review ◽  
Anesthetic Management

scholarly journals The preventive effect of dexmedetomidine on paroxysmal sympathetic hyperactivity in severe traumatic brain injury patients who have undergone surgery: a retrospective study

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e2986 ◽  
Author(s):  
Qilin Tang ◽  
Xiang Wu ◽  
Weiji Weng ◽  
Hongpeng Li ◽  
Junfeng Feng ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Control Group ◽  
Therapeutic Effects ◽  
Preventive Effect ◽  
Sympathetic Hyperactivity ◽  
Paroxysmal Sympathetic Hyperactivity ◽  
Hospital Stays ◽  
The Difference

BackgroundParoxysmal sympathetic hyperactivity (PSH) results and aggravates in secondary brain injury, which seriously affects the prognosis of severe traumatic brain injury patients. Although several studies have focused on the treatment of PSH, few have concentrated on its prevention.MethodsNinety post-operation (post-op) severe traumatic brain injury (sTBI) patients admitted from October 2014 to April 2016 were chosen to participate in this study. Fifty of the post-op sTBI patients were sedated with dexmedetomidine and were referred as the “dexmedetomidine group” (admitted from May 2015 to April 2016). The other 40 patients (admitted from October 2014 to May 2015) received other sedations and were referred as the “control group.” The two groups were then compared based on their PSH scores and the scores and ratios of those patients who met the criteria of “probable,” “possible” and “unlikely” using the PSH assessment measure (PSH-AM) designed by Baguley et al. (2014). The durations of the neurosurgery intensive care unit (NICU) and hospital stays and the Glasgow outcome scale (GOS) values for the two groups were also compared to evaluate the therapeutic effects and the patients’ prognosis.ResultsThe overall PSH score for the dexmedetomidine group was 5.26 ± 4.66, compared with 8.58 ± 8.09 for the control group. The difference between the two groups’ PSH scores was significant (P = 0.017). The score of the patients who met the criterion of “probable” was 18.33 ± 1.53 in the dexmedetomidine group and 22.63 ± 2.97 in the control group, and the difference was statistically significant (P = 0.045). The ratio of patients who were classified as “unlikely” between the two groups was statistically significant (P = 0.028); that is, 42 (84%) in the dexmedetomidine group and 25 (62.5%) in the control group. The differences in NICU, hospital stays and GOS values between the two groups were not significant.ConclusionDexmedetomidine has a preventive effect on PSH in sTBI patients who have undergone surgery.

Incidence of paroxysmal sympathetic hyperactivity following traumatic brain injury using assessment tools

Brain Injury ◽  
2018 ◽  
Vol 32 (9) ◽  
pp. 1115-1121 ◽  
Author(s):  
Sophie Samuel ◽  
Monica Lee ◽  
Robert J Brown ◽  
Huimahn A. Choi ◽  
Ian J Baguley
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Assessment Tools ◽  
Sympathetic Hyperactivity ◽  
Paroxysmal Sympathetic Hyperactivity
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