Dexmedetomidine for paroxysmal sympathetic hyperactivity in a patient with traumatic brain injury: a case report in the intensive care unit

Ismini Lasithiotaki, Aikaterini Megalou, Stefanos Korfias, Stamatis Banos, Charikleia Vrettou


In this case report we describe the course of a patient with severe traumatic brain injury who, upon withdrawal of sedation, presented the characteristic clinical signs of paroxysmal sympathetic hyperactivity and responded to the combination of dexmedetomidine infusion and oral metoprolol. We present the diagnostic and therapeutic rationale that guided our decisions and summarize the current knowledge on the topic.


Paroxysmal sympathetic instability/ hyperactivity, PSH, traumatic brain injury, TBI, dexmedetomidine, ICU

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