Document Detail

Paroxysmal sympathetic storms ("diencephalic seizures") after severe diffuse axonal head injury.
MedLine Citation:
PMID:  9472998     Owner:  NLM     Status:  MEDLINE    
We describe a patient with a severe traumatic head injury who exhibited paroxysmal sympathetic storms, similar to those described in "diencephalic seizures." No epileptiform activity was evident on electroencephalography, and therapeutic levels of anticonvulsants failed to alter the spells; however, use of morphine sulfate abolished them. The features of this and several previously reported cases refute the primary roles of the diencephalon and seizures in this syndrome. Rather, in the setting of already compromised autonomic neuronal integrity, subtle fluctuations in intraventricular pressure or activation of reflexes triggered from muscle mechanoreceptors or chemoreceptors during episodes of hypertonia are more likely. "Paroxysmal sympathetic storms," a more appropriate descriptive term for these phenomena, should be recognized; thus, unnecessary diagnostic evaluations can be minimized, and appropriate therapy can be initiated.
B F Boeve; E F Wijdicks; E E Benarroch; K D Schmidt
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  73     ISSN:  0025-6196     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-02-25     Completed Date:  1998-02-25     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  148-52     Citation Subset:  AIM; IM    
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MeSH Terms
Autonomic Nervous System / drug effects,  physiopathology*
Blood Pressure / drug effects
Body Temperature / drug effects
Bromocriptine / therapeutic use
Craniocerebral Trauma / complications*,  physiopathology
Diencephalon / physiopathology*
Heart Rate / drug effects
Hyperhidrosis / etiology
Morphine / therapeutic use
Respiration / drug effects
Reg. No./Substance:
3A64E3G5ZO/Bromocriptine; 76I7G6D29C/Morphine
Comment In:
Mayo Clin Proc. 1999 Jan;74(1):105   [PMID:  9987541 ]

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