Paroxysmal Sympathetic Hyperactivity (PSH) follows some form of acquired brain injury.
Synonyms: sympathetic storm, hypothalamic dysregulation syndrome, paroxysmal autonomic instability with dystonia
Clinical features:
(1) paroxysms/episodes of sympathetic hyperactivity
(2) associated with acquired brain injury
(2a) traumatic brain injury
(2b) brain tumor or leukemic infiltration
(2c) encephalitis or meningoencephalitis (infectious, autoimmune)
(2d) Guillain-Barre syndrome
(2e) stroke
(2f) tuberculous meningitis
(2g) carbon monoxide poisoning
(2h) brain surgery
(2i) ischemic encephalopathy after cardiac arrest
(2j) hypoglycemic encephalopathy
(3) exclusion of other conditions (sepsis, drug effect, etc)
Clinical features of sympathetic hyperactivity may include:
(1) fever/hyperthermia
(2) tachycardia
(3) tachypnea
(4) hypertension
(5) sweating
(6) dystonia or muscle rigidity
(7) tonic posturing
(8) pupillary dilatation
