• Lisa Letzkus, Jessica Keim-Malpass, and Christine Kennedy.
• a University of Virginia School of Nursing.
• Brain Inj. 2016 Jan 1; 30 (10): 1181-5.

BackgroundChildren who suffer from moderate-to-severe brain injury can develop a complicating phenomenon known as paroxysmal sympathetic hyperactivity (PSH), characterized by autonomic instability and identified clinically as a cluster of symptoms that can include recurrent fever without a source of infection, hypertension, tachycardia, tachypnea, agitation, diaphoresis and dystonia. Studies with adults have demonstrated that this cluster of symptoms is associated with poorer clinical outcomes (prolonged hospitalizations, poorer cognitive and motor function). However, there have been limited studies in children with PSH.ObjectiveTo present a literature review regarding PSH following severe brain injury and highlight research needs in children with PSH.MethodologyElectronic databases (CINAHL, Ovid Medline, Web of Science and Google Scholar) were searched.ResultsThirty-one research articles met the criteria for inclusion. Several themes emerged regarding the phenomenon of interest during the review: nomenclature, symptoms, management and differences between children and adults.ImplicationsThe majority of the research regarding PSH following severe brain injury has been descriptive in nature. Few studies, however, have explored PSH in children with brain injury; therefore, little is known about whether the outcomes of children with PSH are different and, if so, in what ways.

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