title: [A case of paroxysmal sympathetic storm after acute disseminated encephalomyelitis and hypoxic encephalopathy responding to clonidine hydrochloride].
abstract: We report the case of a 17-year-old woman with paroxysmal sympathetic storm (PSS), which was successfully treated with clonidine hydrochloride. The patient was hospitalized for acute disseminated encephalomyelitis in June 2006. Dysphagia led to severe aspiration pneumonia in September 2006, and she suffered cardiopulmonary arrest. She survived but had severe brain damage, with her brain MRI showing diffuse hypoxic encephalopathy. From October 2006, she had several episodes of profound tachypnea (> 60/min), tachycardia (160 to 170 beats/min), hypertension (> 140 mmHg), hyperthermia (39°C), and decerebrate posturing. During the attacks, the levels of catecholamines in the patient's blood and urine were markedly elevated. Accordingly, a diagnosis of PSS associated with hypoxic encephalopathy was made. Her PSS clearly improved after the administration of clonidine hydrochloride (900 μg/day). This case suggests that clonidine hydrochloride, an α2 blocker, may be one therapeutic option for PSS.
authors.affiliation: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Shimmura
authors.forename: Nobutoshi
authors.initials: N
authors.lastname: Kawamura
authors.forename: Takahisa
authors.initials: T
authors.lastname: Tateishi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shigeto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Murai
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Kira
mesh_terms: D000293:Adolescent; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D015415:Biomarkers / Q000097:blood; D002395:Catecholamines / Q000097:blood; D003000:Clonidine / Q000627:therapeutic use*; D004673:Encephalomyelitis, Acute Disseminated / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000188:drug therapy* / Q000209:etiology*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002395:Catecholamines; D003000:Clonidine