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Paroxysmal Sympathetic Hyperactivity: Diagnostic Criteria, Complications, and Treatment after Traumatic Brain Injury

  • Brain Injury Medicine and Rehabilitation (A Wagner, Section Editor)
  • Published:
Current Physical Medicine and Rehabilitation Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Dysautonomia, now known as paroxysmal sympathetic hyperactivity (PSH) is a phenomenon described by fever, hypertension, tachycardia, and diaphoresis among other symptoms affecting patients after traumatic brain injury. The goal of this review is to review the diagnosis, treatment, and outcomes of patients with PSH based on the most current literature.

Recent Findings

Most recently, PSH has been better defined with a specific scoring system that can be applied in the clinical setting. Treatment of PSH is still quite clinically variable.

Summary

PSH has been described for decades, but has only achieved consensus definition. Treatment remains variable institutionally. Much further investigation is needed to systematically assess the multiple currently utilized treatment modalities, and their effect on long-term outcomes based on the current defining criteria.

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Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Statement of authorship

Mina F. Mirhoseini MD, Morgan Hosay Meghan McPherson, and Mayur B. Patel, MD, MPH contributed to the outline, drafting of the manuscript, and conception/design of the review. Mina F. Mirhoseini created tables and figures for the project. All authors critically revised the manuscript and agree to be fully accountable for ensuring the integrity and accuracy of the work. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Section of Surgical Sciences, Department of Surgery, Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Vanderbilt University Medical Center, 1211 21st Avenue South, 404 Medical Arts Building, Nashville, TN, 37212, USA

    Mina F. Mirhoseini, Morgan A. Hosay, Meghan McPherson & Mayur B. Patel

  2. Vanderbilt Center for Health Services Research, Vanderbilt Brain Institute, Vanderbilt ICU Delirium & Cognitive Impairment Study Group, Nashville, USA

    Mayur B. Patel

  3. Surgical Services, Geriatric Research, Education and Clinical Center, US Department of Veterans Affairs, Nashville VA Medical Center, Tennessee Valley Healthcare System, Nashville, USA

    Mayur B. Patel

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  1. Mina F. Mirhoseini
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Correspondence to Mayur B. Patel.

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Conflict of interest

Mayur B. Patel is supported by National Institutes of Health (Bethesda, MD) NHLBI R01 HL111111 and NIGMS R01 GM120484. This work was also supported by REDCap UL1 TR000445 from NCATS/NIH. The authors have no other disclosures relevant to this manuscript.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Brain Injury Medicine and Rehabilitation

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Mirhoseini, M.F., Hosay, M.A., McPherson, M. et al. Paroxysmal Sympathetic Hyperactivity: Diagnostic Criteria, Complications, and Treatment after Traumatic Brain Injury. Curr Phys Med Rehabil Rep 6, 81–88 (2018). https://doi.org/10.1007/s40141-018-0175-z

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  • DOI: https://doi.org/10.1007/s40141-018-0175-z

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