Paroxysmal sympathetic hyperexcitation syndrome caused by ventriculoperitoneal shunt pressure-regulation in post-traumatic hydrocephalus: a case report

Abstract

Paroxysmal sympathetic hyperactivity (PSH) is a rare symptom, but is difficult to manage. Here, we report a case of post-trauma PSH in a young male patient. The main reason for the occurrence of PSH in trauma patients may be nonnoxious or noxious stimuli. In this case, the detection of positive sympathetic parameters and heart rate variability after pressure regulation provided strong evidence for the PSH attack, thus enhancing the accuracy and reliability of early diagnosis. Clinicians should be alert to the possibility of PSH caused by rapid decline of ventricular pressure. Moreover, the appropriate regulation of ventricular pressure combined with pharmacologic interventions, rehabilitation and nutritional support may reduce and control this symptom.