Paroxysmal sympathetic storms ('Diencephalic seizures') after severe diffuse axonal head injury

Bradley F Boeve, E. F M Wijdicks, E. E. Benarroch, K. D. Schmidt

Research output: Contribution to journalArticle

103 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)148-152
Number of pages5
JournalMayo Clinic Proceedings
Volume73
Issue number2
StatePublished - 1998

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Diffuse Axonal Injury
Craniocerebral Trauma
Seizures
Diencephalon
Mechanoreceptors
Ventricular Pressure
Anticonvulsants
Morphine
Reflex
Electroencephalography
Muscles
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Paroxysmal sympathetic storms ('Diencephalic seizures') after severe diffuse axonal head injury. / Boeve, Bradley F; Wijdicks, E. F M; Benarroch, E. E.; Schmidt, K. D.

In: Mayo Clinic Proceedings, Vol. 73, No. 2, 1998, p. 148-152.

Research output: Contribution to journalArticle

Boeve, BF, Wijdicks, EFM, Benarroch, EE & Schmidt, KD 1998, 'Paroxysmal sympathetic storms ('Diencephalic seizures') after severe diffuse axonal head injury', Mayo Clinic Proceedings, vol. 73, no. 2, pp. 148-152.
Boeve, Bradley F ; Wijdicks, E. F M ; Benarroch, E. E. ; Schmidt, K. D. / Paroxysmal sympathetic storms ('Diencephalic seizures') after severe diffuse axonal head injury. In: Mayo Clinic Proceedings. 1998 ; Vol. 73, No. 2. pp. 148-152.
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