PDF(Pubmed)
Abstract：
BACKGROUND: Paroxysmal sympathetic hyperexcitability (PSH) is a group of complex syndromes with various etiologies. Previous studies were limited to the description of traumatic brain injury (TBI), and the description of PSH after other types of brain injury was rare. We explored the clinical features, treatment, and prognosis of PSH after various types of brain injuries.
METHODS: Patients admitted to the neurosurgery intensive care unit with PSH after brain injury from July 2019 to December 2022 were included. Demographic data, clinical manifestations, drug therapy, and disease prognosis were retrospectively collected and analyzed.
RESULTS: Fifteen male and 9 female patients with PSH after brain injury were selected. TBI was most likely to cause PSH (66.7%), followed by spontaneous intracerebral hemorrhage (25%). Glasgow coma scale scores of 19 patients (79.2%) were lower than 8 and 14 patients (58.3%) underwent tracheotomy. Electroencephalogram monitoring was performed in 12 individuals, none of which showed epileptic waves. Clinical symptom scale showed mild symptoms in 17 cases (70.8%). Almost all patients were administered a combination of drugs. After follow-up, most patients had a poor prognosis and 2 (8.3%) died after discharge.
CONCLUSIONS: The etiology of PSH is complex. TBI may be the most common cause of PSH. Non-TBI may also be an important cause of PSH. Therefore, early identification, prevention and diagnosis are helpful for determining the prognosis and outcome of the disease.
METHODS: Patients admitted to the neurosurgery intensive care unit with PSH after brain injury from July 2019 to December 2022 were included. Demographic data, clinical manifestations, drug therapy, and disease prognosis were retrospectively collected and analyzed.
RESULTS: Fifteen male and 9 female patients with PSH after brain injury were selected. TBI was most likely to cause PSH (66.7%), followed by spontaneous intracerebral hemorrhage (25%). Glasgow coma scale scores of 19 patients (79.2%) were lower than 8 and 14 patients (58.3%) underwent tracheotomy. Electroencephalogram monitoring was performed in 12 individuals, none of which showed epileptic waves. Clinical symptom scale showed mild symptoms in 17 cases (70.8%). Almost all patients were administered a combination of drugs. After follow-up, most patients had a poor prognosis and 2 (8.3%) died after discharge.
CONCLUSIONS: The etiology of PSH is complex. TBI may be the most common cause of PSH. Non-TBI may also be an important cause of PSH. Therefore, early identification, prevention and diagnosis are helpful for determining the prognosis and outcome of the disease.
摘要：
背景：阵发性交感神经兴奋过度（PSH）是一组具有多种病因的复杂综合征。以前的研究仅限于描述创伤性脑损伤（TBI），其他类型脑损伤后PSH的描述很少见。我们探索了临床特征，治疗,各种类型脑损伤后PSH的预后。
方法：纳入了2019年7月至2022年12月脑损伤后因PSH进入神经外科重症监护病房的患者。人口统计数据,临床表现，药物治疗,并对疾病预后进行回顾性分析。
结果：选择15例男性和9例女性脑损伤后PSH患者。TBI最有可能导致PSH（66.7％），其次是自发性脑出血（25%）。格拉斯哥昏迷量表评分19例(79.2%)低于气管切开8例(58.3%)。在12个人中进行了脑电图监测，都没有出现癫痫波。临床症状量表显示轻度症状17例(70.8%)。几乎所有患者都服用了药物组合。随访后,大多数患者预后不良,2例(8.3%)患者出院后死亡.
结论：PSH的病因复杂。TBI可能是PSH的最常见原因。非TBI也可能是PSH的重要原因。因此,早期识别,预防和诊断有助于确定疾病的预后和转归。
方法：纳入了2019年7月至2022年12月脑损伤后因PSH进入神经外科重症监护病房的患者。人口统计数据,临床表现，药物治疗,并对疾病预后进行回顾性分析。
结果：选择15例男性和9例女性脑损伤后PSH患者。TBI最有可能导致PSH（66.7％），其次是自发性脑出血（25%）。格拉斯哥昏迷量表评分19例(79.2%)低于气管切开8例(58.3%)。在12个人中进行了脑电图监测，都没有出现癫痫波。临床症状量表显示轻度症状17例(70.8%)。几乎所有患者都服用了药物组合。随访后,大多数患者预后不良,2例(8.3%)患者出院后死亡.
结论：PSH的病因复杂。TBI可能是PSH的最常见原因。非TBI也可能是PSH的重要原因。因此,早期识别,预防和诊断有助于确定疾病的预后和转归。
