陣發性交感神經過度興奮的診治進展_Journal of Epilepsy

Authors：

周傳彬 , 周倩 , 李瑜霞 ,  顧美娟

昆明醫科大學第一附屬醫院老年神內（昆明 650000）;

Corresponding?author：

顧美娟, Email: gmj004288@163.com

Keywords：

陣發性交感神經過度興奮; 量表; 植物神經癲癇; 診斷; 治療

DOI：

10.7507/2096-0247.202111001

Video：

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陣發性交感神經過度興奮（Paroxysmal sympathetic hyperactivity，PSH）是各種急性彌漫性或多灶性腦部疾病的一種相對常見但通常不能正確識別的并發癥。它通常是在某種形式的外部刺激后，反復發作的心動過速、呼吸急促、高血壓、大汗、發熱等交感反應，并出現肌張力及姿勢異常，常易與癲癇疾病混肴。PSH主要依靠臨床診斷，若不能早診斷、早治療，PSH會隨時間惡化，并可能導致嚴重的并發癥。盡管目前關于PSH的治療手段缺乏統一標準，但PSH是可治療的疾病，減少可能觸發發作的任何外部刺激，合理的藥物干預可以減輕病情，改善預后。

Citation： 周傳彬, 周倩, 李瑜霞, 顧美娟. 陣發性交感神經過度興奮的診治進展. 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.	劉曉曉, 郭莉瓊, 王苗, 等. 陣發性交感神經過度興奮綜合征的研究進展. 卒中與神經疾病, 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.	陳炎, 林清, 郭葉群, 等. 慢性意識障礙并發陣發性交感神經過度興奮綜合征的危險因素及其對預后的影響. 臨床神經病學雜志, 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, 姜波濤, 張丹, 等. PSH-AM量表可用于重度顱腦損傷所致陣發性交感神經過度興奮綜合征的診斷. 內科急危重癥雜志, 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. 劉曉曉, 郭莉瓊, 王苗, 等. 陣發性交感神經過度興奮綜合征的研究進展. 卒中與神經疾病, 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. 陳炎, 林清, 郭葉群, 等. 慢性意識障礙并發陣發性交感神經過度興奮綜合征的危險因素及其對預后的影響. 臨床神經病學雜志, 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, 姜波濤, 張丹, 等. PSH-AM量表可用于重度顱腦損傷所致陣發性交感神經過度興奮綜合征的診斷. 內科急危重癥雜志, 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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陣發性交感神經過度興奮的診治進展

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