Paroxysmal autonomic instability with dystonia
Background
- Also referred to as PAID syndrome, or paroxysmal sympathetic hyperactivity (PSH)
- Defined as paroxysmal episodes of sympathetic activity in patients with severe brain injury[1]
- Mechanism remains poorly understood
Clinical Features
- Tachycardia
- Hypertension
- Tachypnea
- Hyperthermia
- Dystonic posturing, typically symmetric
Differential Diagnosis
Evaluation
Workup
Diagnosis
- Clinical diagnosis
Management
- Supportive care
- Reducing stimulation
- Treating hyperthermia
- Pharmacologic therapy: Aimed at attenuating sympathetic activity
- Morphine
- Gabapentin
- Noncardioselective beta blocker
- +/-Clonidine
Disposition
See Also
External Links
References
- ↑ Baguley IJ, Perkes IE, Fernandez-Ortega JF, Rabinstein AA, Dolce G, Hendricks HT; Consensus Working Group. Paroxysmal sympathetic hyperactivity after acquired brain injury: consensus on conceptual definition, nomenclature, and diagnostic criteria. J Neurotrauma. 2014 Sep 1;31(17):1515-20. doi: 10.1089/neu.2013.3301. Epub 2014 Jul 28. PMID: 24731076.