Recent advance in paroxysmal sympathetic hyperactivity

Paroxysmal sympathetic hyperactivity (PSH), which recognized in a subgroup of survivors of severe acquired brain injury, is a syndrome of simultaneous, paroxysmal transient increases in sympathetic (elevated heart rate, blood pressure, respiratory rate, temperature, sweating) and motor (posturing) activity. These symptoms are not specific and can occur in sepsis, epilepsy, malignant hyperthermia, hydrocephalus and many other complications, which is related to confused diagnosis and delayed treatment of PSH. In addition, Patients with PSH have prolonged ICU stays and added healthcare costs. This article discusses the pathophysiological mechanism, clinical diagnostic criteria, and current drug treatment measures of PSH, so as to guide rapid diagnosis. Key words: Paroxysmal sympathetic hyperactivity; Brain injury; Sympathetic storming; Autonomic dysregulation