Paroxysmal sympathetic hyperactivity in a child with tuberculous meningitis:a case study

VernacularTitle:结核性脑膜炎患儿阵发性交感神经过度兴奋1例报告
Author: Yongsheng XU ; Liya WAN ; Jing NING ; Wei GUO
Publication Type:Journal Article
Keywords: tuberculous meningitis; paroxysmal sympathetic hyperactivity; child
From: Journal of Clinical Pediatrics 2016;34(5):351-353
CountryChina
Language:Chinese
Abstract: Objective To report secondary paroxysmal sympathetic hyperactivity in a patient with tuberculous meningitis and to review the diagnostic criteria, clinical features, possible pathogenesis and management of this condition. Methods The clinical data of a case with paroxysmal sympathetic hyperactivity secondary to tuberculous meningitis was retrospectively analyzed and related literature was reviewed. Results A 1-year-old boy was admitted to our institute with a history of lethargy and vomiting for 3 days. Neurological examination revealed abnormalities. A lumbar puncture revealed the evidence of meningitis. PPD test, T-SPOT.TB and radiological examination revealed tuberculous meningitis. Later, when stayed in the intensive care unit, he developed paroxysmal hypertension, sinus tachycardia, tachypnea, dystonia, and high fever. These episodes improved after administration of propranolol, benzodiazepines and artane. Conclusions Paroxysmal sympathetic hyperactivity is a rare manifestation of tuberculous meningitis, early recognition is very important for avoid misdiagnosis and overtreatment.