title: Paroxysmal sympathetic hyperactivity in neurological critical care.
abstract: BACKGROUND
  Paroxysmal sympathetic hyperactivity (PSH) is a clinical disorder mainly caused by traumatic brain injury, stroke, encephalitis and other types of brain injury. The clinical features are episodes of hypertension, tachycardia, tachypnea, fever and dystonic postures. In this study, we described clinical profile and outcome of six patients of PSH admitted in neurocritical care unit.
  
  
  METHODS
  This was a prospective observational study conducted at neurology critical care unit of a tertiary care center. All patients admitted at neurology critical unit during 6-month period from August 2013 to January 2014 were screened for the occurrence of PSH. The clinical details and outcome was documented.
  
  
  RESULTS
  PSH was observed in 6 patients. Male to female ratio was 5:1. Mean age ± SD was 36.67 ± 15.19 years. The leading causes were traumatic brain injury (two patients), stroke (two patients) and Japanese encephalitis (JE) (one patient) and tuberculous meningitis (one patient).
  
  
  CONCLUSIONS
  PSH is an unusual complication in neurocritical care. It prolonged the hospitalization and hampers recovery. The other life-threatening conditions that mimic PSH should be excluded. The association with JE and tuberculous meningitis was not previously described in literature.
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Verma
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Prithvi
authors.initials: P
authors.lastname: Giri
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Imran
authors.initials: I
authors.lastname: Rizvi
keywords: Autonomic seizures; encephalitis; paroxysmal sympathetic hyperactivity; traumatic brain injury