Introduction: Paroxysmal sympathetic storm (PSS) is a rare syndrome characterized by episodic hypertension, hyperhydrosis, hyperthermia, tachycardia, tachypnea, and extensor posturing.
Case Reports: This article describes two cases of PSS: one following traumatic brain injury and the other following cardiac arrest.
Discussion: The first responded to labetalol, morphine, and codeine, whereas the second responded to labetalol.
Conclusion: These observations underscore the importance of central opioid receptors and nonselective beta-adrenergic antagonists in modulating catecholamine pathways.
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Background: Paroxysmal sympathetic hyperactivity (PSH) occurs with high prevalence among critically ill patients with traumatic brain injury (TBI) and is associated with worse outcomes. The PSH-Assessment Measure (PSH-AM) consists of a Clinical Features Scale and a diagnosis likelihood tool (DLT) intended to quantify the severity of sympathetically mediated symptoms and the likelihood that they are due to PSH, respectively, on a daily basis. Here, we aim to identify and explore the value of dynamic trends in the evolution of sympathetic hyperactivity following acute TBI using elements of the PSH-AM.
View Article and Find Full Text PDFParoxysmal sympathetic hyperactivity syndrome caused by meningoencephalitis in children: a case report and literature review.
Front Pediatr
December 2024
Department of Pediatrics, Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China.
Introduction And Importance: Paroxysmal sympathetic hyperactivity (PSH) syndrome often occurs with severe traumatic brain injury. However, it can also occur during infections, such as severe bacterial meningoencephalitis in children. is an aggressive, virulent, opportunistic pathogen.
View Article and Find Full Text PDFPersonalizing Prediction of High Opioid Use in the Neurointensive Care Unit: Development and Validation of a Stratified Risk Model for Acute Brain Injury Due to Stroke or Traumatic Brain Injury.
J Clin Med
November 2024
Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, WA 98104, USA.
Article Synopsis
- - The study created and validated a risk model to predict high opioid use in patients with acute brain injuries (like stroke or TBI) in a neurocritical care setting.
- - Factors identified as significant predictors of high opioid use included patient age, history of anxiety or illicit drug use, admission diagnosis, and certain clinical conditions like mechanical ventilation and intracranial pressure monitoring.
- - The model showed strong reliability with good accuracy and precision, suggesting it could help clinicians tailor opioid prescriptions, though further validation in larger, multi-center studies is needed.
Heart Rate Variability and Cerebral Autoregulation in Patients with Traumatic Brain Injury with Paroxysmal Sympathetic Hyperactivity Syndrome.
Neurocrit Care
October 2024
Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wroclaw University of Science and Technology, Wybrzeze Wyspianskiego 27, 50-370, Wrocław, Poland.
Background: Severe traumatic brain injury (TBI) can lead to transient changes in autonomic nervous system (ANS) functioning and development of paroxysmal sympathetic hyperactivity (PSH) syndrome. Clinical manifestation of ANS disorders may be obscured by therapeutic interventions in TBI. This study aims to analyze ANS metrics and cerebral autoregulation in patients with PSH syndrome to determine their significance in early prognostication.
View Article and Find Full Text PDFParoxysmal sympathetic hyperactivity caused by neurosyphilis.
BMJ Neurol Open
October 2024
Department of Neurology, Tsuchiura Kyodo General Hospital, Tsuchiura-shi, Ibaraki, Japan.
Article Synopsis
- Paroxysmal sympathetic hyperactivity (PSH) is a condition linked to autonomic nervous system dysfunction, often seen in severe brain injuries, but non-traumatic causes like infections can also trigger it.
- A case study discusses a 30-year-old man diagnosed with neurosyphilis who experienced abnormal symptoms like seizures and agitation, leading to a PSH diagnosis after ruling out other conditions.
- Treatment with propranolol, gabapentin, and clonidine successfully managed his PSH symptoms, highlighting the importance of recognizing and addressing PSH early in cases of central nervous system infections.
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