Abstract
Paroxysmal autonomic instability with dystonia, an under-recognized and poorly understood phenomenon of episodic central dysautonomia is associated with various cerebral insults. Treatment options include benzodiazepines, opioids, and gabapentin. Using an illustrative case, we discuss presentation, pathomechanisms, and management of this condition.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Baguley IJ, et al. (2007) Gapabentin in the management of dysautonomia following severe traumatic brain injury: a case series. J Neurol Neurosurg Psychiatr 78:539–541
Baumgartner C, Lurger S, Leutmezer F (2001) Autonomic symptoms during epileptic seizures. Epileptic Disord 3:103–116
Benarroch EE (1997) The central autonomic network. In: Low PA (ed) Clinical autonomic disorders. Lippincott-Raven, Philadelphia pp 17–23
Benarroch EE (1997) Central disorders of autonomic function. In: Low PA (ed) Clinical autonomic disorders. Lippincott-Raven, Philadelphia pp 421–427
Blackman JA, et al. (2004) Paroxysmal autonomic instability with dystonia after brain injury. Arch Neurol 61:321–328
Boeve BF, Wijdicks EF, Benarroch EF, Schmidt KD (1998) Paroxysmal sympathetic storms (diencephalic seizures) after severe diffuse axonal head injury. Mayo Clin Proc 73(2):148–152
Bullard DE (1987) Diencephalic seizures: responsiveness to bromocriptine and morphine. Ann Neurol 21:609–611
Colice GL, et al. (1984) Neurogenic pulmonary edema. Am Rev Respir Dis 130:941
Diesing TS, Wijdicks EF (2006) Arc de cercle and dysautonomia from anoxic injury. Mov Disord 21(6):868–869
Feuerman T, Gade GF, Reynolds R (1988) Stress-induced malignant hyperthermia in a head-injured patient. J Neurosurg 68:297–299
Fox RH, Wilkens DC, Bell JA, et al. (1973) Spontaneous periodic hyperthermia: diencephalic epilepsy. BMJ 2:693–695
Giroud M, Sautreaux JL, Thierry A, Dumas R (1988) Diencephalic epilepsy with congenital suprasellar arachnoid cyst in an infant. Childs Nerv Syst 4(4):252–254
Goh KYC, Conway EJ, DaRosso RC, Muszynski CA, Epstein FJ (1999) Sympathetic storms in a child with a midbrain glioma: a variant of diencephalic seizures. Pediatr Neurol 21(4):742–744
Hirayama K, et al. (1994) Reverse Shapiro’s syndrome. A case of agenesis of corpus callosum associated with periodic hyperthermia. Arch Neurol 51(5):494–496
Penfield W (1929) Diencephalic autonomic epilepsy. Arch Neurol Psychiatr 22:358–374
Rey M, et al. (2005) Paroxysmal sympathetic storms after type A dissection of the aorta. J Cardiothorac Vasc Anesth 19(5):654–655
Ropper AH (1997) Management of the autonomic storm. In: Low PA (ed) Clinical autonomic disorders. Lippincott-Raven, Philadelphia pp 791–801
Rosner NJ (1984) Mechanical brain injury: the sympathoadrenal response. J Neurosurg 61:76–86
Shapiro WR (1969) Spontaneous recurrent hypothermia accompanying agenesis of the corpus callosum. Brain 92:423–436
Spyer KM (1999) Central nervous system control of the cardiovascular system. In: Bannister R, Mathias CJ (eds) Autonomic failure. A textbook of clinical disorders of the autonomic nervous system. Oxford Medical Publications pp 46–54
Talman WT (1985) Cardiovascular regulation and lesions of the central nervous system. Ann Neurol 18:1–13
Talman WT, et al. (1988) A hyperthermic syndrome in two subjects with acute hydrocephalus. Arch Neurol 45:1037–1040
Thorley RR, Wertsch JJ, Klingbeil GE (2001) Acute hypothalamic instability in traumatic brain injury: a case report. Arch Phys Med Rehabil 82(2):246–249
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Srinivasan, S., Lim, C.T. & Thirugnanam, U. Paroxysmal autonomic instability with dystonia. Clin Auton Res 17, 378–381 (2007). https://doi.org/10.1007/s10286-007-0428-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10286-007-0428-x