title: Paroxysmal sympathetic hyperactivity (sympathetic storm) in a patient with permanent vegetative state.
abstract: BACKGROUND
  There are many people living in a permanent vegetative state in the United States. We report the first case of a patient in permanent vegetative state (PVS) who developed paroxysmal sympathetic hyperactivity (sympathetic storm) 8 months after the hypoxic brain injury that lead to PVS.
  
  
  CONCLUSIONS
  Paroxysmal sympathetic hyperactivity is a relatively common complication early in the course of traumatic brain injury. Recognition of the clinical presentation of this syndrome is important to palliative and hospice care providers who may be caring for patients with PVS. The treatment of sympathic hyperactivity to reduce potential physical suffering includes medications targeted to the sympathetic nervous system.
authors.affiliation: University of California San Francisco School of Medicine, San Francisco, California, USA.
authors.forename: Emily R
authors.initials: ER
authors.lastname: Levy
authors.forename: Ursula
authors.initials: U
authors.lastname: McVeigh
authors.forename: Allan M
authors.initials: AM
authors.lastname: Ramsay
mesh_terms: D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000503:physiopathology*; D001930:Brain Injuries / Q000150:complications; D003657:Decision Making; D006323:Heart Arrest / Q000150:complications / Q000628:therapy; D017051:Hospice Care; D006801:Humans; D008020:Life Support Care; D008297:Male; D010146:Pain / Q000150:complications / Q000175:diagnosis / Q000209:etiology; D010166:Palliative Care; D018458:Persistent Vegetative State; D011368:Professional-Family Relations; D019966:Substance-Related Disorders / Q000150:complications / Q000628:therapy; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D013997:Time Factors