ARTIGO REVISÃO
Algarve Médico, 2021; 17 (5): 10 – 11
REVIEW ARTICLE
Paroxysmal Sympathetic Hyperactivity - An Underdiagnosed Entity Daniela Costa Martins1, Edgar Amorim2, Bruna Melo2, Ana Catarina Matias2 1
. Physical and Rehabilitation Medicine Department, Algarve Hospital Center, Faro, Portugal; .Physical and Rehabilitation Medicine Department, Braga Hospital, Braga, Portugal
2.
costamartins.daniela@gmail.com
Abstract Paroxysmal Sympathetic Hyperactivity (PSH) was recently defined by an international group as a syndrome recognized in survivors of severe acquired brain injury with simultaneous paroxysmal transient increases in sympathetic and motor activity. This entity is underdiagnosed and if the treatment doesn´t start early it can change the prognosis. It can appear after traumatic brain injury but also in other cerebral pathologies. This brief report was performed to summarize the PSH since the symptoms to the treatment in a way to alert clinicians for this problem which usually starts in the intensive care units.
Keywords: Paroxysmal Sympathetic Hyperactivity, traumatic brain injury, early treatment
After several decades of inconsistent
The author believes that although this
It is estimated that around 8-33% of patients
terminology, the term “Paroxysmal
syndrome transverse to several medical
with moderate to severe TBI develop PSH,
Sympathetic Hyperactivity (PSH)” was
specialties, it is underdiagnosed with
with no clear correlation between the
defined in 2014 by an international
subsequent delayed initial treatment
severity of the injury and the risk of PSH.
Steering Committee group as a
and direct repercussions on clinical and
Although mostly affecting patients with
“syndrome recognized in a subgroup of
functional prognosis. This is the main
moderate to severe TBI, PSH may also
survivors of severe acquired brain injury
reason for this brief report.
occur in association with hypoxic-ischemic
of simultaneous paroxysmal transient increases in sympathetic (elevated heart rate, blood pressure, respiratory rate, temperature, sweating) and motor (posturing) activity”.
With the standardization of the term, a growing number of literatures has emerged, so the authors intend to summarize the current knowledge and alert the medical community to the importance of recognizing and treating this syndrome, as well as the urge for more studies regarding new effective therapies.
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injury, stroke, hydrocephalus, tumors and infections. The symptoms usually start during the acute phase in the intensive care unit but it can be prolonged or even initiated in the subacute or chronic phases.
