[1]潘濛,徐亚男,张璇,等.阵发性交感神经过度兴奋2例报道及相关文献复习[J].卒中与神经疾病杂志,2017,24(03):230-233.[doi:10.3969/j.issn.1007-0478.2017.03.015]
　Pan Meng,Xu Yanan,Zhang Xuan,et al.Two patients with paroxysmal sympathetic hyperactivity: clinical experiences and literature review[J].Stroke and Nervous Diseases,2017,24(03):230-233.[doi:10.3969/j.issn.1007-0478.2017.03.015]
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阵发性交感神经过度兴奋2例报道及相关文献复习()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第24卷
期数:
2017年03期
页码:
230-233
栏目:
论 著
出版日期:
2017-06-26

文章信息/Info

Title:
Two patients with paroxysmal sympathetic hyperactivity: clinical experiences and literature review
文章编号:
1007-0478(2017)03-0230-04
作者:
潘濛; 徐亚男; 张璇; 郭文静; 王雅楠; 陆军
221000 江苏徐州医科大学附属医院神经内科
Author(s):
Pan Meng;  Xu Yanan;  Zhang Xuan;  et al.
Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000
关键词:
阵发性交感神经过度兴奋 脑损伤 β受体阻滞剂 加巴喷丁
Keywords:
Paroxysmal sympathetic hyperactivity Brain damage β-blockers Gabapentin
分类号:
R747
DOI:
10.3969/j.issn.1007-0478.2017.03.015
摘要:
目的 探讨阵发性交感神经过度兴奋(paroxysmal sympathetic hyperactivity,PSH)的临床特征、诊断和治疗。方法 对2例PSH患者的病程、临床表现及辅助检查及诊疗过程进行分析。结果 2例患者中1例是脑干出血患者,另1例是大面积脑梗死患者。2例患者均以阵发性躁动、高热、大汗、血压升高、心动过速、呼吸急促及肌张力障碍等为主要临床表现。发作间期格拉斯哥昏迷评分分别为5和15分。2例患者均行脑电图检查,均未见癫痫波。神经影像学检查提示额叶、颞叶、顶叶、脑干等部位损伤。23例抗癫痫药物治疗无效; β受体阻滞剂和加巴喷丁联合应用对PSH有较好疗效。结论 不同病因、不同程度脑干出血与脑梗死均可导致PSH。PSH易被误诊为癫痫,抗癫痫治疗无效。β受体阻滞剂和加巴喷丁联合治疗有效。
Abstract:
ObjectiveTo investigate the clinical characteristics, diagnose and treatment of paroxysmal sympathetic hyperactivity.Methods The clinical manifestations, auxiliary examinations, diagnosis and treatment process of 2 patients with PSH were analyzed in this research.Results There were a brainstem hemorrhage patient and a large area cerebral infarction patient. Both of them had suffered from paroxysmal agitation, high fever, sweating, blood pressure, tachycardia, and shortness of breath and dystonia symptoms. During the attack period the Glasgow Coma Scale scores of 2 patients were 5 and 15 points respectively. No epilepsy waves were discovered in EEG examination. Neural imaging examination had demonstrated that frontal lobe, temporal lobe, parietal lobe and brain stem were damaged. Anti-epileptic drug treatment of 23 cases was invalid, while the combined application of β-blockers and gabapentin had a good curative effect.Conclusion Both brainstem hemorrhage and cerebral infarction could lead to PSH. PSH could be misdiagnosed as epilepsy and anti-epileptic treatment was invalid. The combination therapy of β-blockers and garmentin was effective.

参考文献/References:

[1] Penfield W.Diencephalic autonomic epilepsy[J].Arch Neurol Psychiatry,1929,22(2):358-374.
[2] Rabinstein A.Paroxysmal sympathetic hyperactivity in the neurological intensive care unit[J].J Neurol,2007,254(3):37.
[3] Raithel,S D,Ohler KH,et al.Morphine:an effective abortive therapy for pediatric paroxysmal sympathetic hyperactivity after hypoxic brain injury[J].J Pediatr Pharmacol Ther,2015,20(4):335-340.
[4] 厉含之,李国良,李琛,等.阵发性交感神经过度兴奋10例患者的临床特征分析[J].中华神经科杂志,2013,46(3):159-163.
[5] 沈咏慧,丁美萍.阵发性交感神经活动过度综合征的研究现状[J].中华神经科杂志,2013,46(4):269-272.
[6] Baguley IJ,Heriseanu RE,Cameron ID,et al.A critical review of the pathophysiology of dysautonomia following traumatic brain injury[J].Neurocrit Care,2008,8(2):293-300.
[7] 谢翠英.阵发性交感神经过度兴奋的治疗进展[J].临床合理用药杂志,2012,5(26):166-167.
[8] Fernandez-Ortega F,F J,Baguley IJ,et al.Catecholamines and paroxysmal sympathetic hyperactivity after traumatic brain injury[J]. J Neurotrauma,2017,34(1):109-114.
[9] Blackman JA,Patrick PD,Buck ML,et al.Paroxysmal autonomic instability with dystonia after brain injury[J].Arch Neurol,2004,61(3):321-328.
[10] Baguley IJ,Cameron ID,Green AM,et al.Pharmacological management of Dysautonomia following traumatic brain injury[J].Brain Injury,2004,18(5):409-417.
[11] Lee,S,Jun GW,et al.Paroxysmal sympathetic hyperactivity in brainstem-compressing huge benign tumors:clinical experiences and literature review[Z],2016:340.
[12] Hinson HE,Puybasset L,Weiss N,et al.Neuroanatomical basis of paroxysmal sympathetic hyperactivity: A diffusion tensor imaging analysis[J].Brain Injury,2015,29(4):455-461.

更新日期/Last Update: 2017-06-20