• Journal of neurotrauma · Aug 2019

    Observational Study

    Paroxysmal Sympathetic Hyperactivity rate in patients in vegetative or minimally conscious state due to severe acquired brain injury evaluated by PSH assessment measure.

    • Lucia Francesca Lucca, Loris Pignolo, Elio Leto, Maria Ursino, Stefania Rogano, and Antonio Cerasa.
    • 1S. Anna Institute and RAN-Research in Advanced Neurorehabilitation, Crotone, Italy.
    • J. Neurotrauma. 2019 Aug 15; 36 (16): 2430-2434.

    AbstractThe rate of paroxysmal sympathetic hyperactivity (PSH) was retrospectively assessed using the Paroxysmal Sympathetic Hyperactivity-Assessment Measure (PSH-AM) scale in patients with disorders of consciousness attributed to traumatic and non-traumatic acquired brain injury during the rehabilitation phase. These results were compared with previous studies carried out in the same clinical scenario, in order to verify the prevalence of PSH signs from 1998 to 2014. The entire sample consisted of 140 patients in vegetative state/unresponsive wakefulness syndrome or minimally conscious state admitted to a neurorehabilitation subacute unit from June 2010 to December 2014. PSH-AM revealed the presence of PSH in 16% of traumatic and 12% of non-traumatic younger patients. In the non-traumatic group, the rate was higher in patients with anoxia-hypoxia (37.5%) etiology than those with vascular brain injury (6.7%). A comparison with previous studies revealed a reduction in the number of PSH cases in traumatic patients. This study provides evidence that PSH-AM can be used prospectively to detect the rate of PSH and stratify severity of signs. Further longitudinal analysis is warranted to confirm the prevalence of PSH signs in non-traumatic brain injured patients.

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