SCCM Resource Library-Weathering the Storm: What's New in the Treatment of Paroxysmal Sympathetic Hyperactivity, Neuropathic Pain, Spasticity, and Dystonia

Weathering the Storm: What's New in the Treatment of Paroxysmal Sympathetic Hyperactivity, Neuropathic Pain, Spasticity, and Dystonia

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Video Transcription

Video Summary

The presentation focused on the treatment of paroxysmal sympathetic hyperactivity (PSH) in pediatric patients. It highlighted that PSH is characterized by episodic sympathetic and motor hyperactivity after brain injuries, with symptoms like tachycardia and hypertension. Recognizing pain in such patients is crucial, yet challenging due to overlapping symptoms. The talk emphasized considering non-pharmacologic treatments initially, such as reducing environmental stimuli and ensuring adequate supportive care. Pharmacological management involves both abortive and preventative therapies using medications such as morphine, dexmedetomidine, propofol, and benzodiazepines. Each has pros and cons; for instance, morphine has a rapid onset but risks respiratory depression, while dexmedetomidine avoids this risk but can cause hypotension. Preventative medications discussed include propranolol and clonidine for sympathetic modulation, with gabapentin and baclofen addressing neuropathic pain and spasticity, respectively. The talk concluded by advocating for individualized treatment based on patient-specific factors, as current guidelines for managing pediatric PSH are lacking.

Asset Caption

One-Hour Concurrent Session | Optimizing ICU Care and Decision-Making for Children and AYAs With Severe Neurologic Impairment

Meta Tag

Content Type Presentation

Membership Level Professional

Membership Level Select

Year 2024

Keywords

Paroxysmal Sympathetic Hyperactivity

Pediatric Treatment

Non-pharmacologic Therapy

Pharmacological Management

Individualized Care

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