Hyperbaric oxygen therapy in the management of paroxysmal sympathetic hyperactivity after severe traumatic brain injury: a report of 6 cases

Arch Phys Med Rehabil. 2011 Sep;92(9):1515-8. doi: 10.1016/j.apmr.2011.01.014. Epub 2011 May 26.


Paroxysmal sympathetic hyperactivity (PSH) after severe brain injury is detrimental to the recovery of patients. Pharmacologic management of PSH is difficult and efficacy is unpredictable or incomplete. This report presents 6 cases of PSH after extremely severe traumatic brain injury in which hyperbaric oxygen therapy (HBOT) controlled paroxysmal autonomic changes and posturing in the early subacute phase after limited success with conventional medication regimens. Thus, HBOT may present an option for the management of PSH in addition to pharmacologic therapy. Potential mechanisms for these effects are discussed.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Autonomic Nervous System Diseases / etiology*
  • Autonomic Nervous System Diseases / therapy*
  • Brain Injuries / complications*
  • Child
  • Female
  • Humans
  • Hyperbaric Oxygenation / methods*
  • Male