• Brain injury : [BI] · Jan 2013

    Comparative Study

    How does dysautonomia influence the outcome of traumatic brain injured patients admitted in a neurorehabilitation unit?

    • Sara Laxe, Rosa Terré, Daniel León, and Montserrat Bernabeu.
    • Brain Injury Unit, Institut Guttmann-Universitat Autonoma de Barcelona , Badalona , Spain.
    • Brain Inj. 2013 Jan 1; 27 (12): 1383-7.

    BackgroundPatients surviving severe traumatic brain injury (TBI) may suffer from symptoms presumed to be related to an excessive sympathetic production known as paroxysmal sympathetic hyperactivity (PSH). While this condition is more common in the acute phase, prognosis is less clear in rehabilitation settings.AimThe goal of this study is to describe the functional status of patients with PSH admitted in a rehabilitation hospital and to determine its prognostic influence during rehabilitation.MethodsA cohort study was undertaken of all the patients admitted in a neurorehabilitation hospital suffering from PSH. Functional outcomes were reported according to the Glasgow outcome scale-extended (GOSE), the Disability Rating Scale (DRS) and the Functional Independence Measure (FIM).ResultsThirteen out of 39 patients suffered symptoms compatible with PSH. Neuroimaging of PSH patients showed more diffuse lesions. The FIM at admission was lower in the PSH group who was transferred for rehabilitation at an earlier stage. At discharge no differences were seen using the FIM, DRS and GOS-E.ConclusionsFunctional status is similar and PSH does not appear to influence recovery during the rehabilitation, although PSH patients are more likely to undergo psychoactive medications and special care is needed to approach their caregivers that perceive PSH as a complication for rehabilitation.

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