TY - CHAP M1 - Book, Section TI - Paroxysmal Sympathetic Hyperactivity A1 - Samuel, Sophie A1 - Choi, H. Alex A1 - Lee, Kiwon A2 - Lee, Kiwon PY - 2017 T2 - The NeuroICU Book, 2e AB - The patient is a 19-year-old man who was in a motor vehicle collision and was brought to the emergency department for management of traumatic brain injury. On arrival he was Glasgow Coma Scale (GCS) of 5. A computed tomography (CT) scan showed diffuse cerebral edema. An intracranial pressure (ICP) monitor was placed, and he had aggressive medical measures to control ICP. By hospital day 7 his ICPs are under control. On day 14 he develops episodes of tachycardia, increased respiratory rate, fever, diaphoresis, and dystonic posturing occurring 8 to 10 times per day. Vital signs are temperature, 38.9°C; heart rate, 130 bpm; respiratory rate, 32 breaths/min; and blood pressure, 180/75 mm Hg. Neurological assessment is as follows: he localizes on the left side but is paretic on the right side. GCS of 10: eye 3, verbal 3, motor 4. Pupils are reactive to light, and other brainstem reflexes were intact. A CT of the head shows no significant changes. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - neurology.mhmedical.com/content.aspx?aid=1143954412 ER -