重型颅脑外伤后阵发性交感神经过度兴奋综合征2例并文献复习

Paroxysmal sympathetic hyperexcitation syndrome after severe craniocerebral injury report of 2 cases and review of literature

目的探讨重型颅脑外伤后阵发性交感神经过度兴奋综合征(PSH)的临床特征、诊断及治疗。方法对2例重型颅脑外伤后PSH患者的临床特征、诊疗过程进行回顾性分析。结果2例患者均为年轻男性,均诊断为重型颅脑外伤,伤后20余天出现PSH症状。最初按癫痫或菌血症治疗未见缓解,此后选用普萘洛尔、地西泮发作时及发作间期进行治疗及预防,患者PSH症状逐步减轻,发作频率亦逐步减少,最后症状消失,在院期间未再次发作。结论普萘洛尔联合地西泮可作为PSH的主要治疗方法,以防止症状持续发作或产生不良预后。

Objective To explore the clinical features,diagnosis and treatment of paroxysmal sympathetic hyperexcitability(PSH) after severe head injury.Methods The clinical characteristics,diagnosis and treatment process of 2 patients with PSH were analyzed retrospectively.Results Both patients were young males,both of whom were diagnosed with severe head injury.Symptoms of PSH appeared more than 20 days after the injury.Initially,the treatment of epilepsy or bacteremia was not relieved.After that,propranolol and diazepam were used for treatment and prevention during and between seizures.The patient's PSH symptoms gradually alleviated and the frequency of seizures gradually decreased.Finally,the symptoms disappeared.There was no recurrence during the hospital.Conclusion Propranolol combined with diazepam can be used as the main treatment method for PSH to prevent the symptoms from persisting or producing bad prognosis.