Paroxysmal Sympathetic Hyperactivity after Cardiac Arrest in a Young Male

Singh, Tavankit; Arora, Tanureet; Bedi, Prabhjot Singh; Kashinath, Sanjana Kalvehalli

doi:10.7759/cureus.3028

Cited by 2 publications

(1 citation statement)

References 20 publications

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“…Focal brain injury is unlikely to lead to PSH development. Global, diffuse, or multifocal brain damage is usually present [ 14 ]. PSH is associated with diffuse axonal injury (DAI) and damage to the periventricular white matter, corpus callosum, mesencephalon, and upper brain stem [ 15 ].…”

Section: Neuroimagingmentioning

confidence: 99%

Paroxysmal Sympathetic Hyperactivity After Acquired Brain Injury: An Integrative Review of Diagnostic and Management Challenges

Xu,

Zhang,

2023

Neurol Ther

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Paroxysmal sympathetic hyperactivity (PSH) mainly occurs after acquired brain injury (ABI) and often presents with high fever, hypertension, tachycardia, tachypnea, sweating, and dystonia (increased muscle tone or spasticity). The pathophysiological mechanisms of PSH are not fully understood. Currently, there are several views: (1) disconnection theory, (2) excitatory/inhibitory ratio, (3) neuroendocrine function, and (4) neutrophil extracellular traps. Early diagnosis of PSH remains difficult, given the low specificity of its diagnostic tools and unclear pathogenesis. According to updated case analyses in recent years, PSH is now more commonly observed in patients with stroke, with tachycardia and hypertension as the main clinical manifestations, which is not fully consistent with previous data. To date, the PSH Assessment Measure tool is optimal for the early identification of PSH and stratification of symptom severity. Clinical strategies for the management of PSH are divided into three main points: (1) reduction of stimulation, (2) reduction of sympathetic excitatory afferents, and (3) inhibition of the effects of sympathetic hyperactivity on target organs. However, use of drugs and standards have not yet been harmonized. Further investigation on the relationship between PSH severity and long-term neurological prognosis in patients with ABI is required. This review aimed to determine the diagnostic and management challenges encountered in PSH after ABI.

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Section: Neuroimagingmentioning

confidence: 99%

Paroxysmal Sympathetic Hyperactivity After Acquired Brain Injury: An Integrative Review of Diagnostic and Management Challenges

Xu,

Zhang,

2023

Neurol Ther

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Paroxysmal Sympathetic Hyperactivity After Acquired Brain Injury: An Integrative Literature Review

Seo

2023

Critical Care Nurse

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Background Paroxysmal sympathetic hyperactivity may occur in patients with acute brain injury and is associated with physical disability, poor clinical outcomes, prolonged hospitalization, and higher health care costs. Objective To comprehensively review current literature and provide information about paroxysmal sympathetic hyperactivity for nurses. Methods An integrative literature review was conducted according to Whittemore and Knafl’s method. The search was conducted from October 2020 through January 2021. The main targets of the literature search were definition, incidence rate, causes, clinical characteristics, pathophysiology, diagnosis, and treatment of paroxysmal sympathetic hyperactivity in pediatric and adult patients. The results were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results The most characteristic clinical features of paroxysmal sympathetic hyperactivity are hypertension, tachycardia, tachypnea, hyperthermia, diaphoresis, and abnormal motor posturing. Reported incidence rates of paroxysmal sympathetic hyperactivity in patients with brain injury range from 8% to 33%. Various diagnostic criteria have been proposed; most are based on clinical symptoms. Ruling out other causes of the signs and symptoms of paroxysmal sympathetic hyperactivity is important because the signs and symptoms are nonspecific. The major goals of paroxysmal sympathetic hyperactivity management are avoidance of stimuli that may trigger a paroxysmal episode, inhibition of sympathetic overactivity, and prevention of damage to other organs. Conclusions Critical care nurses should be aware of the signs and symptoms of paroxysmal sympathetic hyperactivity in patients with acute brain injury. Early identification is important to ensure timely treatment for patients with paroxysmal sympathetic hyperactivity.

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Paroxysmal Sympathetic Hyperactivity after Cardiac Arrest in a Young Male

Cited by 2 publications

References 20 publications

Paroxysmal Sympathetic Hyperactivity After Acquired Brain Injury: An Integrative Review of Diagnostic and Management Challenges

Paroxysmal Sympathetic Hyperactivity After Acquired Brain Injury: An Integrative Review of Diagnostic and Management Challenges

Paroxysmal Sympathetic Hyperactivity After Acquired Brain Injury: An Integrative Literature Review

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