阵发性交感神经过度兴奋的诊治进展_Journal of Epilepsy

Authors：

周传彬 , 周倩 , 李瑜霞 ,  顾美娟

昆明医科大学第一附属医院老年神内（昆明 650000）;

Corresponding author：

顾美娟, Email: gmj004288@163.com

Keywords：

阵发性交感神经过度兴奋; 量表; 植物神经癫痫; 诊断; 治疗

DOI：

10.7507/2096-0247.202111001

Video：

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阵发性交感神经过度兴奋（Paroxysmal sympathetic hyperactivity，PSH）是各种急性弥漫性或多灶性脑部疾病的一种相对常见但通常不能正确识别的并发症。它通常是在某种形式的外部刺激后，反复发作的心动过速、呼吸急促、高血压、大汗、发热等交感反应，并出现肌张力及姿势异常，常易与癫痫疾病混肴。PSH主要依靠临床诊断，若不能早诊断、早治疗，PSH会随时间恶化，并可能导致严重的并发症。尽管目前关于PSH的治疗手段缺乏统一标准，但PSH是可治疗的疾病，减少可能触发发作的任何外部刺激，合理的药物干预可以减轻病情，改善预后。

Citation： 周传彬, 周倩, 李瑜霞, 顾美娟. 阵发性交感神经过度兴奋的诊治进展. Journal of Epilepsy, 2022, 8(3): 256-259. doi: 10.7507/2096-0247.202111001 Copy

1.	Fernandez OJF, Prieto PMA, Garcia CM, et al: Paroxysmal sympathetic hyperactivity after traumatic brain injury: clinical and prognostic implications. J Neurotrauma, 2012, 29: 1364–1370.
2.	Baguley IJ, Slewa-Younan S, Heriseanu RE, et al. The incidence of dysautonomia and its relationship with autonomic arousal following traumatic brain injury. Brain Inj, 2007, 21: 1175–1181.
3.	Baguley IJ, Perkes IE, Fernandez-Ortega JF, et al. Consensus Working Group. Paroxysmal sympathetic hyperactivity after acquired brain injury:consensus on conceptual definition, nomenclature, and diagnostic criteria. J Neurotrauma, 2014, 31(17): 1515-1520.
4.	Baguley IJ, Lee Monica, Samuel Sophie, et al. Incidence of paroxysmal sympathetic hyperactivity following traumatic brain injury using assessment tools. Brain Injury, 2018, 32(9): 1115-1121.
5.	刘晓晓, 郭莉琼, 王苗, 等. 阵发性交感神经过度兴奋综合征的研究进展. 卒中与神经疾病, 2019, 26(6): 777-779.
6.	Yusuke M, Kouhei N, Kimiya S, et al. Efficacy of trazodone for treating paroxysmal sympathetic hyperactivity presenting after thalamic hemorrhage: A case report. Drug Discoveries & Therapeutics, 2019, 13(3): 168-171.
7.	陈炎, 林清, 郭叶群, 等. 慢性意识障碍并发阵发性交感神经过度兴奋综合征的危险因素及其对预后的影响. 临床神经病学杂志, 2019, 32(5): 359-363.
8.	Verma R, Giri P, Rizvu I. Paroxysmal sympathetic hyperactivity in neurological critical care. Indian J Crit Care Med, 2015, 19: 34-37.
9.	Geert Meyfroidt, Ian J Baguley, David K Menon. Paroxysmal sympathetic hyperactivity: the storm after acute brain injury. Lancet Neurol, 2017, 16: 721-729.
10.	Feng Y, Zheng X, Fang ZC. Treatment progress of paroxysmal sympathetic hyperactivity after acquired brain injury. Pediatr Neurosurg, 2015, 50: 301-309.
11.	Baguley IJ. The excitatory: inhibitory ratio model (EIR model): an integrative explanation of acute autonomic overactivity syndromes. Med Hypotheses, 2008, 70: 26-35.
12.	Huang P, Lin WC, Huang PK, et al. Susceptibility weighted imaging in a patient with paroxysmal sympathetic storms. J Neurol, 2009, 256(02): 276-278.
13.	Lv LQ, Hou LJ, Yu MK, et al. Prognostic influence and magnetic resonance imaging findings in paroxysmal sympathetic hyperactivity after severe traumatic brain injury. J Neurotrauma, 2010, 27: 1945-1950.
14.	van Eijck MM, Sprengers MOP, Oldenbeuving AW, et al. The use of the PSH-AM in patients with diffuse axonal injury and autonomic dysregulation: A cohort study and review. J Crit Care, 2019, 49: 110-117.
15.	Hinson HE, Puybasset L, Weiss N, et al. Neuro Imaging for Coma Emergence, Recovery (NICER) Consortium: Neuroanatomical basis of paroxysmal sympathetic hyperactivity: A diffusion tensor imaging analysis. Brain Inj, 2015, 29: 455-461.
16.	Renner CI. Interrelation between neuroendocrine disturbances and medical complications encountered during rehabilitation after TBI. J Clin Med, 2015, 4: 1815-1840.
17.	Femandez OJ, Baguley f, Gates TA , et al. Catecholamines and paroxysmal sympa-thetic hyperactivity after traumatic brain injury. J Neurotrauma, 2017, 34(1): 109-114.
18.	Mohammed H, Alysa A, Frederick AZ. Autonomic dysfunction and associations with functional and neurophysiologic outcome in moderate/severe traumatic brain injury: a scoping review. J Neurotrauma, 2018, 36: 1491-1504.
19.	唐璐, 姜波涛, 张丹, 等. PSH-AM量表可用于重度颅脑损伤所致阵发性交感神经过度兴奋综合征的诊断. 内科急危重症杂志, 2021, 27(4): 290-293.
20.	Tu JSY, Reeve J, Deane AM, et al. Pharmacological management of Paroxysmal Sympathetic Hyperactivity: a Scoping review. J Neurotrauma, 2021, 38(16): 2221-2237.
21.	Raithel DS, Ohler KH, Porto I, et al. Morphine: an effective abortive therapy for pediatric paroxysmal sympathetic hyperactivity after hypoxic brain injury. J Pediatr Pharmacol Ther, 2015, 20(4): 335-340.
22.	Schroeppel TJ, Sharpe JP, Magnotti LJ, et al. Traumatic brain injury and β-blockers: not all drugs are created equal. J Trauma Acute Care Surg, 2014, 76(2): 504-509.
23.	Caldwell SB, Smith D, Wilson FC. Impact of paroxysmal sympathetic hyperactivity on nutrition management after brain injury: a case series. Brain Inj, 2014, 28(3): 370-373.
24.	Lv LQ, Hou LJ, Yu MK, et al. Hyperbaric oxygen therapy in the management of paroxysmal sympathetic hyperactivity after severe traumatic brain injury: a report of 6 cases. Arch Phys Med Rehabil, 2011, 92(9): 1515-1518.
25.	Picton JD, Marino AB, Nealy KL. Benzodiazepine use and cognitive decline in the elderly. Am J Health Syst Pharm, 2018, 75(1): e6-e12.
26.	Samuel S, Allison TA, Lee K, et al. Pharmacologic management of Paroxysmal Sympathetic Hyperactivity after brain injury. J Neurosci Nurs, 2016, 48(2): 82-89.
27.	Winter G, Beni-Adani L, Ben-Pazi H. Intrathecal baclofen therapy-practical approach: clinical benefits and complication management. J Child Neurol, 2018, 33(11): 734-741.
28.	Podell JE, Miller SS, Jaffa MN, et al. Admission features associated with paroxysmal sympathetic hyperactivity after traumatic brain injury: a case-control study. Crit Care Med, 2021, 49(10): e989-e1000.

1. Fernandez OJF, Prieto PMA, Garcia CM, et al: Paroxysmal sympathetic hyperactivity after traumatic brain injury: clinical and prognostic implications. J Neurotrauma, 2012, 29: 1364–1370.
2. Baguley IJ, Slewa-Younan S, Heriseanu RE, et al. The incidence of dysautonomia and its relationship with autonomic arousal following traumatic brain injury. Brain Inj, 2007, 21: 1175–1181.
3. Baguley IJ, Perkes IE, Fernandez-Ortega JF, et al. Consensus Working Group. Paroxysmal sympathetic hyperactivity after acquired brain injury:consensus on conceptual definition, nomenclature, and diagnostic criteria. J Neurotrauma, 2014, 31(17): 1515-1520.
4. Baguley IJ, Lee Monica, Samuel Sophie, et al. Incidence of paroxysmal sympathetic hyperactivity following traumatic brain injury using assessment tools. Brain Injury, 2018, 32(9): 1115-1121.
5. 刘晓晓, 郭莉琼, 王苗, 等. 阵发性交感神经过度兴奋综合征的研究进展. 卒中与神经疾病, 2019, 26(6): 777-779.
6. Yusuke M, Kouhei N, Kimiya S, et al. Efficacy of trazodone for treating paroxysmal sympathetic hyperactivity presenting after thalamic hemorrhage: A case report. Drug Discoveries & Therapeutics, 2019, 13(3): 168-171.
7. 陈炎, 林清, 郭叶群, 等. 慢性意识障碍并发阵发性交感神经过度兴奋综合征的危险因素及其对预后的影响. 临床神经病学杂志, 2019, 32(5): 359-363.
8. Verma R, Giri P, Rizvu I. Paroxysmal sympathetic hyperactivity in neurological critical care. Indian J Crit Care Med, 2015, 19: 34-37.
9. Geert Meyfroidt, Ian J Baguley, David K Menon. Paroxysmal sympathetic hyperactivity: the storm after acute brain injury. Lancet Neurol, 2017, 16: 721-729.
10. Feng Y, Zheng X, Fang ZC. Treatment progress of paroxysmal sympathetic hyperactivity after acquired brain injury. Pediatr Neurosurg, 2015, 50: 301-309.
11. Baguley IJ. The excitatory: inhibitory ratio model (EIR model): an integrative explanation of acute autonomic overactivity syndromes. Med Hypotheses, 2008, 70: 26-35.
12. Huang P, Lin WC, Huang PK, et al. Susceptibility weighted imaging in a patient with paroxysmal sympathetic storms. J Neurol, 2009, 256(02): 276-278.
13. Lv LQ, Hou LJ, Yu MK, et al. Prognostic influence and magnetic resonance imaging findings in paroxysmal sympathetic hyperactivity after severe traumatic brain injury. J Neurotrauma, 2010, 27: 1945-1950.
14. van Eijck MM, Sprengers MOP, Oldenbeuving AW, et al. The use of the PSH-AM in patients with diffuse axonal injury and autonomic dysregulation: A cohort study and review. J Crit Care, 2019, 49: 110-117.
15. Hinson HE, Puybasset L, Weiss N, et al. Neuro Imaging for Coma Emergence, Recovery (NICER) Consortium: Neuroanatomical basis of paroxysmal sympathetic hyperactivity: A diffusion tensor imaging analysis. Brain Inj, 2015, 29: 455-461.
16. Renner CI. Interrelation between neuroendocrine disturbances and medical complications encountered during rehabilitation after TBI. J Clin Med, 2015, 4: 1815-1840.
17. Femandez OJ, Baguley f, Gates TA , et al. Catecholamines and paroxysmal sympa-thetic hyperactivity after traumatic brain injury. J Neurotrauma, 2017, 34(1): 109-114.
18. Mohammed H, Alysa A, Frederick AZ. Autonomic dysfunction and associations with functional and neurophysiologic outcome in moderate/severe traumatic brain injury: a scoping review. J Neurotrauma, 2018, 36: 1491-1504.
19. 唐璐, 姜波涛, 张丹, 等. PSH-AM量表可用于重度颅脑损伤所致阵发性交感神经过度兴奋综合征的诊断. 内科急危重症杂志, 2021, 27(4): 290-293.
20. Tu JSY, Reeve J, Deane AM, et al. Pharmacological management of Paroxysmal Sympathetic Hyperactivity: a Scoping review. J Neurotrauma, 2021, 38(16): 2221-2237.
21. Raithel DS, Ohler KH, Porto I, et al. Morphine: an effective abortive therapy for pediatric paroxysmal sympathetic hyperactivity after hypoxic brain injury. J Pediatr Pharmacol Ther, 2015, 20(4): 335-340.
22. Schroeppel TJ, Sharpe JP, Magnotti LJ, et al. Traumatic brain injury and β-blockers: not all drugs are created equal. J Trauma Acute Care Surg, 2014, 76(2): 504-509.
23. Caldwell SB, Smith D, Wilson FC. Impact of paroxysmal sympathetic hyperactivity on nutrition management after brain injury: a case series. Brain Inj, 2014, 28(3): 370-373.
24. Lv LQ, Hou LJ, Yu MK, et al. Hyperbaric oxygen therapy in the management of paroxysmal sympathetic hyperactivity after severe traumatic brain injury: a report of 6 cases. Arch Phys Med Rehabil, 2011, 92(9): 1515-1518.
25. Picton JD, Marino AB, Nealy KL. Benzodiazepine use and cognitive decline in the elderly. Am J Health Syst Pharm, 2018, 75(1): e6-e12.
26. Samuel S, Allison TA, Lee K, et al. Pharmacologic management of Paroxysmal Sympathetic Hyperactivity after brain injury. J Neurosci Nurs, 2016, 48(2): 82-89.
27. Winter G, Beni-Adani L, Ben-Pazi H. Intrathecal baclofen therapy-practical approach: clinical benefits and complication management. J Child Neurol, 2018, 33(11): 734-741.
28. Podell JE, Miller SS, Jaffa MN, et al. Admission features associated with paroxysmal sympathetic hyperactivity after traumatic brain injury: a case-control study. Crit Care Med, 2021, 49(10): e989-e1000.

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