Paroxysmal Sympathetic Hyperactivity after Severe Traumatic Brain Injury in Children: A Retrospective Case Series

Abstract

Paroxysmal sympathetic hyperactivity (PSH), a common sequelae of traumatic brain injury (TBI), is a clinical condition characterized by features of sympathetic hyperactivity. Though there is a substantial literature on adults, the data on children are lacking. We did a retrospective analysis of severe TBI (Glasgow Coma Scale [GCS] ≤8) pediatric patients over a period of 1 year. PSH was noted in 16.7% (5/30) of the children after severe TBI. The mean (standard deviation, SD) age of the patients was 3.4 (1.14) years. The mean (SD) time to occurrence of PSH after TBI was found to be 12.8 (1.92) days. All five cases responded to therapies usually advocated for the management of PSH in adults with a mean duration of recovery of 4.2 (1.09) days. Early diagnosis and prompt treatment initiation is the key to manage PSH.