Diagnosis and Treatment of Paroxysmal Sympathetic Hyperactivity in Medical ICU, University of Gondar Hospital, Northwest Ethiopia: A Case Report

International Medical Case Reports Journal
Nebiyu BekeleAbilo Tadesse

Abstract

Paroxysmal sympathetic hyperactivity (PSH) is a neurologic syndrome characterized by paroxysmal and simultaneous occurrence of hypertension, hyperpyrexia, tachycardia, tachypnea, diaphoresis and dystonic posturing due to surge in sympathetic outflow after acquired brain injuries. Diagnosis of PSH is made using the paroxysmal sympathetic hyperactivity-assessment measure (PSH-AM) score, which comprises "clinical features severity" (CFS) score and "diagnosis likelihood tool" (DLT) score. A 35-year-old woman diagnosed to have echo-proven chronic rheumatic heart disease for 25 years. Percutaneous balloon mitral valvotomy was done 6 weeks previously for severe mitral stenosis. Left atrial thrombus was detected after the procedure and anticoagulant (warfarin) was initiated. She presented with severe headache and repeated vomiting of 1 day duration on arrival to the hospital. She had frequent seizure attacks with subsequent loss of consciousness on third day of admission. Diagnosis of status epilepticus secondary to intracranial hemorrhage due to warfarin toxicity was made after CT-scan revealed acute subdural hematoma and ventricular bleeding. Then she was transferred to medical intensive care unit (ICU), intubated and put on mechanic...Continue Reading

References

Jan 5, 2008·Neurological Research·Alejandro A Rabinstein
Aug 10, 2010·Annals of Neurology·Iain PerkesDavid K Menon
Jun 20, 2013·Current Neurology and Neuroscience Reports·H Alex ChoiKiwon Lee
Jan 8, 2015·Brain Injury : [BI]·Holly E HinsonUNKNOWN Neuro Imaging for Coma Emergence, Recovery (NICER) Consortium
Mar 10, 2016·The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses·Sophie SamuelHuimahn A Choi
Aug 18, 2017·Lancet Neurology·Geert MeyfroidtDavid K Menon
Dec 20, 2017·Medicina intensiva·D A GodoyF Murillo-Cabezas
Mar 13, 2020·Frontiers in Neurology·Rui-Zhe ZhengGuang-Ming Zhang

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.