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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2022; 41(01): e70-e75
DOI: 10.1055/s-0041-1730370
Review Article

Paroxysmal Sympathetic Hyperactivity in Patients Victims of Traumatic Brain Injury: Literature Review

Hiperatividade simpática paroxística em pacientes vítimas de trauma cranioencefálico: Revisão da literatura
Gabriela Ferreira Kalkmann 
1   Medical Faculty, Universidade Federal do Paraná, Curitiba, PR, Brazil
,
Letícia Novak Crestani 
2   Medical Faculty, Faculdade de Medicina do Centro Universitário de Maringá, Maringá, PR, Brazil
,
Letícia Adrielle dos Santos 
3   Medical Faculty, Universidade Federal de Sergipe, Aracaju, SE, Brazil
,
Carlos Umberto Pereira 
4   Neurosurgery Service, Hospital Urgência de Sergipe, Preceptor of the Neurosurgery Residency at Surgery Hospital Charitable Foundation, Aracaju, SE, Brazil
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Abstract

The present literature review aims to present the physiology of paroxysmal sympathetic hyperactivity (PSH) as well as its clinical course, conceptualizing them, and establishing its diagnosis and treatment. Paroxysmal sympathetic hyperactivity is a rare syndrome, which often presents after an acute traumatic brain injury. Characterized by a hyperactivity of the sympathetic nervous system, when diagnosed in its pure form, its symptomatologic presentation is through tachycardia, tachypnea, hyperthermia, hypertension, dystonia, and sialorrhea. The treatment of PSH is basically pharmacological, using central nervous system suppressors; however, the nonmedication approach is closely associated with a reduction in external stimuli, such as visual and auditory stimuli. Mismanagement can lead to the development of serious cardiovascular and diencephalic complications, and the need for neurosurgeons and neurointensivists to know about PSH is evident in order to provide a fast and accurate treatment of this syndrome.

Resumo

O presente artigo de revisão de literatura tem como objetivo apresentar a fisiologia da hiperatividade simpática paroxística (HPS), bem como sua evolução clínica, conceituando-as, estabelecendo seu diagnóstico e o tratamento. A HPS é uma síndrome rara, que geralmente se apresenta após uma lesão cerebral traumática aguda. A HPS é caracterizada por uma hiperatividade do sistema nervoso simpático, e quando diagnosticada na sua forma pura, apresenta sintomatologia através de taquicardia, taquipneia, hipertermia, hipertensão, distonia e sialorreia. O tratamento da HPS é basicamente farmacológico, por meio do uso de supressores do sistema nervoso central, porém a abordagem não medicamentosa está intimamente associada à redução de estímulos externos, como visuais e auditivos. A má gestão pode levar ao desenvolvimento de complicações cardiovasculares e diencefálicas graves, e a necessidade de neurocirurgiões e neurointensivistas saberem sobre o HSP para fornecer um tratamento rápido e preciso dessa síndrome é evidente.

Keywords

autonomic nervous system - craniocerebral trauma - primary dysautonomias

Palavras-chave

disautonomias primárias - sistema nervoso autonômico - trauma craniocerebral


Publication History

Received: 08 June 2020

Accepted: 22 February 2021

Article published online:
17 December 2021

© 2021. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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