Paroxysmal autonomic nerve dysfunction after severe traumatic brain injury surgery: four cases report and review of literature

Abstract

Paroxysmal autonomic nerve dysfunction is a relatively rare clinical syndrome, and is clinically diagnosed based on the combined presence of sympathetic hyperactivity and parasympathetic hyperactivity. Early diagnosis of paroxysmal autonomic nerve dysfunction is difficult because its early clinical manifestations are complicated and varied, and it is easily misdiagnosed as central high fever, hospital infection, and so on. The causes and mechanism of the disease are complex, and there is no effective preventive measures. This paper will report 4 cases of patients with severe traumatic brain injury (TBI) who suffered from episodes of this disease. The effective therapies include bromocriptine, propranolol, physical cooling and hyperbaric oxygen therapy. The report also provides review of literature about paroxysmal autonomic nerve dysfunction, in order to improve diagnosis and treatment of the disease.

doi: 10.3969/j.issn.1672-6731.2014.07.016