Paroxysmal Sympathetic Hyperactivity rate in patients in vegetative or minimally conscious state due to severe acquired brain injury evaluated by PSH assessment measure.

The rate of paroxysmal sympathetic hyperactivity was retrospectively assessed using the Paroxysmal Sympathetic Hyperactivity--Assessment Measure (PSH-AM) scale in patients with disorders of consciousness due to traumatic and non-traumatic acquired brain injury during the rehabilitation phase.These results were compared with previous studies carried out in the same clinical scenario, in order to verify the prevalence of PSH signs from 1998 to 2014. The entire sample consisted of 140 patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) or minimally conscious state (MCS) admitted to a neurorehabilitation subacute unit from June 2010 to December 2014. PSH-AM revealed the presence of paroxysmal sympathetic hyperactivity in 16% of traumaticand 12% of non-traumaticyounger patients. In the non-traumatic group, the rate was higher in patients withanoxia-hypoxia(37.5%) aetiology thanthose with vascular brain injury (6.7%).A comparison with previous studies revealed a reduction in the number of PSH cases in traumatic patients. This study provides evidence that PSH-AM can be used prospectively to detect the rate of PSH and to stratify severity of signs. Further longitudinal analysis is warranted to confirm the prevalence of PSH signs in non-traumatic brain injured patients.