Paroxysmal sympathetic hyperactivity (sympathetic storm) in a patient with permanent vegetative state.

BACKGROUND There are many people living in a permanent vegetative state in the United States. We report the first case of a patient in permanent vegetative state (PVS) who developed paroxysmal sympathetic hyperactivity (sympathetic storm) 8 months after the hypoxic brain injury that lead to PVS. DISCUSSION Paroxysmal sympathetic hyperactivity is a relatively common complication early in the course of traumatic brain injury. Recognition of the clinical presentation of this syndrome is important to palliative and hospice care providers who may be caring for patients with PVS. The treatment of sympathic hyperactivity to reduce potential physical suffering includes medications targeted to the sympathetic nervous system.

[1]  B. Jennett.  The vegetative state , 2002, Journal of neurology, neurosurgery, and psychiatry.

[2]  Steven Laureys,et al.  The vegetative state , 2010, BMJ : British Medical Journal.

[3]  B. Malika,et al.  Palliative care needs of patients with neurologic or neurosurgical conditions , 2008 .

[4]  J. Blackman,et al.  Paroxysmal autonomic instability with dystonia after brain injury. , 2004, Archives of neurology.

[5]  A. Rabinstein.  Paroxysmal sympathetic hyperactivity in the neurological intensive care unit , 2007, Neurological research.

[6]  B. Boeve,et al.  Paroxysmal sympathetic storms ("diencephalic seizures") after severe diffuse axonal head injury. , 1998, Mayo Clinic proceedings.

[7]  David K Menon,et al.  A review of paroxysmal sympathetic hyperactivity after acquired brain injury , 2010, Annals of neurology.

[8]  I. Baguley,et al.  Autonomic Complications Following Central Nervous System Injury , 2008, Seminars in neurology.

[9]  I. Baguley,et al.  Dysautonomia after traumatic brain injury: a forgotten syndrome? , 1999, Journal of neurology, neurosurgery, and psychiatry.

[10]  Gustave Moonen,et al.  Cortical Processing of Noxious Somatosensory Stimuli in the Persistent Vegetative State , 2002, NeuroImage.

[11]  Ian J. Baguley,et al.  The incidence of dysautonomia and its relationship with autonomic arousal following traumatic brain injury , 2007, Brain injury.

[12]  Multi-Society Task Force on Pvs.  Medical aspects of the persistent vegetative state (2). , 1994, The New England journal of medicine.