Propranolol for Paroxysmal Sympathetic Hyperactivity with Lateralizing Hyperhidrosis after Stroke

Brain injury can lead to impaired cortical inhibition of the hypothalamus, resulting in increased sympathetic nervous system activation. Symptoms of paroxysmal sympathetic hyperactivity may include hyperthermia, tachycardia, tachypnea, vasodilation, and hyperhidrosis. We report the case of a 41-year...

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Main Authors: Jason W. Siefferman, George Lai
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Neurological Medicine
Online Access:http://dx.doi.org/10.1155/2015/421563
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author Jason W. Siefferman
George Lai
author_facet Jason W. Siefferman
George Lai
author_sort Jason W. Siefferman
collection DOAJ
description Brain injury can lead to impaired cortical inhibition of the hypothalamus, resulting in increased sympathetic nervous system activation. Symptoms of paroxysmal sympathetic hyperactivity may include hyperthermia, tachycardia, tachypnea, vasodilation, and hyperhidrosis. We report the case of a 41-year-old man who suffered from a left middle cerebral artery stroke and subsequently developed central fever, contralateral temperature change, and hyperhidrosis. His symptoms abated with low-dose propranolol and then returned upon discontinuation. Restarting propranolol again stopped his symptoms. This represents the first report of propranolol being used for unilateral dysautonomia after stroke. Propranolol is a lipophilic nonselective beta-blocker which easily crosses the blood-brain barrier and may be used to treat paroxysmal sympathetic hyperactivity.
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spelling doaj-art-94ae2d8921f4428a983e379f9f6d5fbe2025-08-20T02:09:48ZengWileyCase Reports in Neurological Medicine2090-66682090-66762015-01-01201510.1155/2015/421563421563Propranolol for Paroxysmal Sympathetic Hyperactivity with Lateralizing Hyperhidrosis after StrokeJason W. Siefferman0George Lai1Department of Neurology, VA New York Harbor Healthcare System, 423 East 23rd Street No. 127, New York, NY 10010, USADepartment of Neurology, Mount Sinai Beth Israel Medical Center, New York, NY 10003, USABrain injury can lead to impaired cortical inhibition of the hypothalamus, resulting in increased sympathetic nervous system activation. Symptoms of paroxysmal sympathetic hyperactivity may include hyperthermia, tachycardia, tachypnea, vasodilation, and hyperhidrosis. We report the case of a 41-year-old man who suffered from a left middle cerebral artery stroke and subsequently developed central fever, contralateral temperature change, and hyperhidrosis. His symptoms abated with low-dose propranolol and then returned upon discontinuation. Restarting propranolol again stopped his symptoms. This represents the first report of propranolol being used for unilateral dysautonomia after stroke. Propranolol is a lipophilic nonselective beta-blocker which easily crosses the blood-brain barrier and may be used to treat paroxysmal sympathetic hyperactivity.http://dx.doi.org/10.1155/2015/421563
spellingShingle Jason W. Siefferman
George Lai
Propranolol for Paroxysmal Sympathetic Hyperactivity with Lateralizing Hyperhidrosis after Stroke
Case Reports in Neurological Medicine
title Propranolol for Paroxysmal Sympathetic Hyperactivity with Lateralizing Hyperhidrosis after Stroke
title_full Propranolol for Paroxysmal Sympathetic Hyperactivity with Lateralizing Hyperhidrosis after Stroke
title_fullStr Propranolol for Paroxysmal Sympathetic Hyperactivity with Lateralizing Hyperhidrosis after Stroke
title_full_unstemmed Propranolol for Paroxysmal Sympathetic Hyperactivity with Lateralizing Hyperhidrosis after Stroke
title_short Propranolol for Paroxysmal Sympathetic Hyperactivity with Lateralizing Hyperhidrosis after Stroke
title_sort propranolol for paroxysmal sympathetic hyperactivity with lateralizing hyperhidrosis after stroke
url http://dx.doi.org/10.1155/2015/421563
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