Paroxysmal Sympathetic Hyperactivity: An Old but Unrecognized Condition

  • Filipa Brás Monteiro Internal Medicine Department, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon
  • Ricardo Castro Fonseca Internal Medicine Department, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon
  • Rita Mendes Internal Medicine Department, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon
Keywords: Paroxysmal Sympathetic Activity (PSH), Traumatic Brain Injury (TBI), Fever, beta-blocker

Abstract

Patients who survive a traumatic brain injury (TBI) can sometimes experience symptoms of excessive sympathetic discharge. Despite being known about for more than 60 years, the diagnostic criteria for this condition have only recently been defined under the name "paroxysmal sympathetic hyperactivity". Failure to recognize this syndrome leads to excessive costs, prolonged hospital stays and delayed recovery for TBI patients. This case report describes a patient whose specific rehabilitation program was affected by a failure to identify this entity, even though he presented with many of the characteristics of this condition.

Author Biographies

Filipa Brás Monteiro, Internal Medicine Department, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon
Internal Medicine Resident
Ricardo Castro Fonseca, Internal Medicine Department, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon
Endocrinology Resident
Rita Mendes, Internal Medicine Department, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon
Internal Medicine Consultant

References

  • Mathew MJ, Deepika A, Shukla D, Devi BI, Ramesh VJ. Paroxysmal sympathetic hyperactivity in severe traumatic brain injury. Acta Neurochir 2016;158:2047–2052.

  • Baguley IJ, Perkes IE, Fernandez-Ortega J-F, Rabinstein AA, Dolce G, Hendricks HT, for the Consensus Working Group. Paroxysmal sympathetic hyperactivity after acquired brain injury: consensus on conceptual definition, nomenclature, and diagnostic criteria. J Neurotrauma 2014;31:1515–1520.

  • Samuel S, Allison TA, Lee K, Choi HA. Pharmacological management of paroxysmal sympathetic hyperactivity. J Neurosci Nurs 2016;48:82–89.

  • Perkes I, Baguley IJ, Nott MT, Menon DK. A review of paroxysmal sympathetic hyperactivity after acquired brain injury. Ann Neurol 2010;68:126–135.

  • Meyer KS. Understanding paroxysmal sympathetic hyperactivity after traumatic brain injury. Surg Neurol Int 2014;5(Suppl 13):S490–492.
  • Published: 2017-04-27

    Issue: Vol 4 No 3 (view)

    Section: Articles

    How to cite:
    Monteiro, F., Fonseca, R., & Mendes, R. (2017). Paroxysmal Sympathetic Hyperactivity: An Old but Unrecognized Condition. European Journal of Case Reports in Internal Medicine, 4(3). https://doi.org/https://doi.org/10.12890/2017_000562

    Most read articles by the same author(s)