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Overview Overview
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General Features of Autonomic Hyperactivity General Features of Autonomic Hyperactivity
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Pathophysiology Pathophysiology
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Complications Complications
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Principles of Management Principles of Management
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Hypertension Hypertension
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Arrhythmias Arrhythmias
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Paroxysmal Sympathetic Hyperactivity in Severe Head Injury Paroxysmal Sympathetic Hyperactivity in Severe Head Injury
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Typical Features Typical Features
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Representative Case Representative Case
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Differential Diagnosis Differential Diagnosis
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Management Management
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Subarachnoid Hemorrhage Subarachnoid Hemorrhage
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Focal Disorders Focal Disorders
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Insular Stroke Insular Stroke
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Seizures Seizures
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Paroxysmal Hypothermia with Hyperhidrosis Paroxysmal Hypothermia with Hyperhidrosis
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Brainstem Lesions Brainstem Lesions
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Autonomic Hyperactivity Associated with Subacute Encephalopathy Autonomic Hyperactivity Associated with Subacute Encephalopathy
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Delirium Tremens Delirium Tremens
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Fatal Insomnia Fatal Insomnia
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Autoimmune Encephalitis Autoimmune Encephalitis
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Limbic Encephalitis Associated with Lgi1 Antibodies Limbic Encephalitis Associated with Lgi1 Antibodies
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Morvan Syndrome Morvan Syndrome
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Anti-Nmda Receptor Encephalitis Anti-Nmda Receptor Encephalitis
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Autonomic Hyperactivity in Spinal Cord Disorders Autonomic Hyperactivity in Spinal Cord Disorders
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Autonomic Dysreflexia in Spinal Cord Injury Autonomic Dysreflexia in Spinal Cord Injury
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Autonomic Hyperactivity in Peripheral Nerve Disorders Autonomic Hyperactivity in Peripheral Nerve Disorders
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Guillain-Barré Syndrome Guillain-Barré Syndrome
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Iatrogenic Causes of Autonomic Hyperactivity Iatrogenic Causes of Autonomic Hyperactivity
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References References
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Cite
Abstract
Autonomic hyperactivity is a life-threatening manifestation of many disorders affecting the central or peripheral nervous systems. Sympathetic hyperactivity manifests with hypertension, tachyarrhythmias, hyperhidrosis, peripheral vasoconstriction, and hyperthermia or hypothermia.Massive sympathoexcitation can lead to intracranial hemorrhage, vasogenic brain edema, congestive heart failure, apical ballooning (Takotsubo) syndrome, and neurogenic pulmonary edema. Less commonly, autonomic hyperactivity also involves the parasympathetic system and manifests primarily with bradyarrhythmia or even syncope. Common causes of autonomic hyperactivity are head trauma, hypoxic brain injury, subarachnoid hemorrhage, autonomic dysreflexia in spinal cord injury, Guillain-Barré syndrome,and iatrogenic disorders such as neuroleptic malignant syndrome and serotonin syndrome.Autonomic hyperactivity in the setting of cognitive, psychiatric or sleep disturbances suggests alcohol (or other depressant drug) withdrawal, fatal insomnia, or limbic encephalitis. Patients with autonomic hyperactivity should be managed in an intensive care unit as they require continuous monitoring of cardiac rhythm, blood pressure, respiration, and fluid balance.
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