Tuesday, October 22, 2019


Q: Paroxysmal sympathetic hyperactivity (PSH) after traumatic brain injury (TBI) is? (select one) 

A) symmetric 
B) asymmetric

Answer: A

Paroxysmal sympathetic hyperactivity (PSH), popularly known as sympathetic storm is a disorder of regulation of autonomic function commonly seen with severe traumatic brain injury. The presentation is usually very dramatic with tachycardia, systolic hypertension with elevated pulse pressures, tachypnea, diaphoresis, sometimes high fever, and in severe cases dystonic posturing which is typically symmetric.



Hughes JD, Rabinstein AA. Early diagnosis of paroxysmal sympathetic hyperactivity in the ICU. Neurocrit Care 2014; 20:454. 

 Perkes IE, Menon DK, Nott MT, Baguley IJ. Paroxysmal sympathetic hyperactivity after acquired brain injury: a review of diagnostic criteria. Brain Inj 2011; 25:925.

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