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 REVIEW ARTICLE
Year : 2022  |  Volume : 70  |  Issue : 2  |  Page : 485--490

Understanding and Managing Autonomic Disorders in the Neurocritical Care Unit: A Comprehensive review


Department of Neurology, Aster Medcity, Kothad, Kochi, Kerala, India

Correspondence Address:
Dr. Siddharth Bhattacharjee
12B, Asset Ocean Grove Apartment, South Chittoor, Ernakulam, Kochi, Kerala - 682 027
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.344657

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Background: For a favorable outcome, patients admitted to critical care units require continuous monitoring and swift decision-making ability regarding management. One of the biggest challenges in neurocritical care units is the identification and management of autonomic dysfunction and in the worst-case scenario, autonomic storms. Objective: Most of the literature available focuses mainly on autonomic storms following traumatic brain injury. However, due to the myriad neurological presentations in a critical care setting, it is particularly important for physicians and intensivists to suspect and manage autonomic dysfunction in various neurological scenarios. Methods: Understanding the mechanism of paroxysmal sympathetic hyperactivity (PSH) is essential for early recognition and treatment. PSH-AM is an assessment measurement scale to diagnose and assess the severity of PSH in traumatic brain injury. However, this is not yet standardized across all neurological settings. Conclusion: We present a comprehensive report on understanding the mechanism of autonomic storms across various neurological disorders and outline the management.






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