Paroxysmal sympathetic hyperactivity
From IDWiki
Background
Pathophysiology
- Thought to be damage to inhibitory sympathetic centres of the diencephalon
- This allows spinal cord stimuli to be amplify through uninhibited positive feedback
Epidemiology
- 80% of patients with PSH have traumatic brain injury
Clinical Presentation
- Episodes of increased sympathetic output triggered by external stimulation
- Symptoms most commonly include tachycardia, diaphoresis, and increased motor activity
- Other symptoms include fever (up to 70%), hypertension, and tachypnea
Management
- Treated with beta blockers, especially propanolol
- May add clonidine for better blood pressure control