Godoy D A, Panhke P, Guerrero Suarez P D, Murillo-Cabezas F
Unidad de Cuidados Neurointensivos, Sanatorio Pasteur, Catamarca, Argentina; Unidad de Terapia Intensiva, Hospital San Juan Bautista, Catamarca, Argentina.
Shock Room, Hospital Municipal de Urgencias, Córdoba, Argentina.
Med Intensiva (Engl Ed). 2019 Jan-Feb;43(1):35-43. doi: 10.1016/j.medin.2017.10.012. Epub 2017 Dec 15.
Paroxysmal sympathetic hyperactivity (PSH) is a potentially life-threatening neurological emergency secondary to multiple acute acquired brain injuries. It is clinically characterized by the cyclic and simultaneous appearance of signs and symptoms secondary to exacerbated sympathetic discharge. The diagnosis is based on the clinical findings, and high alert rates are required. No widely available and validated homogeneous diagnostic criteria have been established to date. There have been recent consensus attempts to shed light on this obscure phenomenon. Its physiopathology is complex and has not been fully clarified. However, the excitation-inhibition model is the theory that best explains the different aspects of this condition, including the response to treatment with the available drugs. The key therapeutic references are the early recognition of the disorder, avoiding secondary injuries and the triggering of paroxysms. Once sympathetic crises occur, they must peremptorily aborted and prevented. of the later the syndrome is recognized, the poorer the patient outcome.
阵发性交感神经过度兴奋（PSH）是继发于多种急性获得性脑损伤的一种潜在危及生命的神经急症。其临床特征为交感神经放电加剧继发的体征和症状呈周期性同时出现。诊断基于临床发现，需要高度警惕。迄今为止，尚未建立广泛可用且经过验证的统一诊断标准。最近有人试图就这一晦涩现象达成共识。其生理病理学复杂，尚未完全阐明。然而，兴奋 - 抑制模型是最能解释该病症不同方面的理论，包括对现有药物治疗的反应。关键的治疗参考要点是早期识别该病症、避免继发性损伤以及触发发作。一旦交感神经危机发生，必须立即终止并预防。该综合征被识别得越晚，患者预后越差。
