Autonomic Dysfunction after Traumatic Brain Injury

ABSTRACT

Patients following traumatic brain injury (TBI) sometimes display paroxysmal autonomic and muscle overactivity, which is suspicious to self-limiting or permanent disability. There are still no standard definition and diagnostic tools for autonomic dysfunction after TBI. Dysautonomia has been used as the most dominant term by authors of papers, was defined as simultaneous paroxysmal increases in at least five out of the seven features (heart rate, respiratory rate, blood pressure, temperature, posturing, dystonia and sweating) with episodes persisting for at least 2 weeks after injury. Heart rate variability (HRV) may be helpful to diagnosis the dysautonomia. The available evidence for managing of dysautonomia was intravenous morphine, Gabapentin, Bromocriptine and intrathecal baclofen infusion. Therefore, future efforts should be targeted at multicenter, large sample studies to make the diagnostic criteria and to evaluate the incidence, natural history and management of autonomic dysfunction after TBI.