• Indian J Crit Care Med · Jan 2015

    Paroxysmal sympathetic hyperactivity in neurological critical care.

    • Rajesh Verma, Prithvi Giri, and Imran Rizvi.
    • Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
    • Indian J Crit Care Med. 2015 Jan 1;19(1):34-7.

    IntroductionParoxysmal sympathetic hyperactivity (PSH) is a clinical disorder mainly caused by traumatic brain injury, stroke, encephalitis and other types of brain injury. The clinical features are episodes of hypertension, tachycardia, tachypnea, fever and dystonic postures. In this study, we described clinical profile and outcome of six patients of PSH admitted in neurocritical care unit.Materials And MethodsThis was a prospective observational study conducted at neurology critical care unit of a tertiary care center. All patients admitted at neurology critical unit during 6-month period from August 2013 to January 2014 were screened for the occurrence of PSH. The clinical details and outcome was documented.ResultsPSH was observed in 6 patients. Male to female ratio was 5:1. Mean age ± SD was 36.67 ± 15.19 years. The leading causes were traumatic brain injury (two patients), stroke (two patients) and Japanese encephalitis (JE) (one patient) and tuberculous meningitis (one patient).ConclusionPSH is an unusual complication in neurocritical care. It prolonged the hospitalization and hampers recovery. The other life-threatening conditions that mimic PSH should be excluded. The association with JE and tuberculous meningitis was not previously described in literature.

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