Baguley Ian J, Heriseanu Roxana E, Gurka Joseph A, Nordenbo Annette, Cameron Ian D
Brain Injury Rehabilitation Service, Westmead Hospital, PO Box 533, Wentworthville NSW 2145, Australia.
J Neurol Neurosurg Psychiatry. 2007 May;78(5):539-41. doi: 10.1136/jnnp.2006.096388.
The pharmacological management of dysautonomia, otherwise known as autonomic storms, following acute neurological insults, is problematic and remains poorly researched. This paper presents six subjects with dysautonomia following extremely severe traumatic brain injury where gabapentin controlled paroxysmal autonomic changes and posturing in the early post-acute phase following limited success with conventional medication regimens. In two subjects, other medications were reduced or ceased without a recurrence of symptoms. It is proposed that medications that can block or minimise abnormal afferent stimuli may represent a better option for dysautonomia management than drugs which increase inhibition of efferent pathways. Potential mechanisms for these effects are discussed.
急性神经损伤后，自主神经失调（又称自主神经风暴）的药物治疗存在问题，且研究仍然不足。本文介绍了6例极重度创伤性脑损伤后发生自主神经失调的患者，在常规药物治疗方案效果有限的情况下，加巴喷丁在急性后期早期控制了阵发性自主神经变化和姿势异常。在2例患者中，其他药物减少或停用后症状未复发。有人提出，与增加传出通路抑制作用的药物相比，能够阻断或最小化异常传入刺激的药物可能是治疗自主神经失调的更好选择。文中还讨论了这些作用的潜在机制。
