Paroxysmal autonomic instability with dystonia after severe traumatic brain injury: A case report

Abstract

Paroxysmal autonomic instability with dystonia (PAID) is a clinical syndrome characterized by episodes of systemic hypertension, tachycardia, tachypnea, hyperthermia, diaphoresis, intermitent agitation and certain forms of dystonia (decerebrate or decorticate posturing, rigidity and spasticity). It is a relatively uncommon complication of distinct cerebral conditions: traumatic brain injury, hydrocephalus, spontaneous subarachnoid or intracerebral hemorrhage, non traumatic brain anoxia. Lack of recognising and undertreatment of this syndrome can increase the risk of secondary injury to the brain. The incidence of complete syndrome of PAID is low; we present a case of posttraumatic PAID displaying the full clinical picture, aggravated by the occurence of sepsis.