Research Reports - How does dysautonomia influence the outcome of traumatic brain injured patients admitted in a neurorehabilitation unit?

Brain Inj. 2013;27(12):1383-7

Laxe S, Terré R, León D, Bernabeu M

Abstract Background: Patients surviving severe traumatic brain injury (TBI) may
suffer from symptoms presumed to be related to an excessive sympathetic
production known as paroxysmal sympathetic hyperactivity (PSH). While this
condition is more common in the acute phase, prognosis is less clear in
rehabilitation settings. Aim: The goal of this study is to describe the
functional status of patients with PSH admitted in a rehabilitation hospital and
to determine its prognostic influence during rehabilitation. Methods: A cohort
study was undertaken of all the patients admitted in a neurorehabilitation
hospital suffering from PSH. Functional outcomes were reported according to the
Glasgow outcome scale-extended (GOSE), the Disability Rating Scale (DRS) and the
Functional Independence Measure (FIM). Results: Thirteen out of 39 patients
suffered symptoms compatible with PSH. Neuroimaging of PSH patients showed more
diffuse lesions. The FIM at admission was lower in the PSH group who was
transferred for rehabilitation at an earlier stage. At discharge no differences
were seen using the FIM, DRS and GOS-E. Conclusions: Functional status is similar
and PSH does not appear to influence recovery during the rehabilitation, although
PSH patients are more likely to undergo psychoactive medications and special care
is needed to approach their caregivers that perceive PSH as a complication for
rehabilitation.

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