What are the signs and symptoms of hyperstimulation of the sympathetic nervous system in drowning?

Updated: Jun 19, 2019
  • Author: G Patricia Cantwell, MD, FCCM; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Autonomic instability (diencephalic/hypothalamic storm) is common following severe traumatic, hypoxic, or ischemic brain injury. These patients often present with signs and symptoms of hyperstimulation of the sympathetic nervous system, including the following:

  • Tachycardia

  • Hypertension

  • Tachypnea

  • Diaphoresis

  • Agitation

  • Muscle rigidity

Autonomic instability has also been found to present as takotsubo stress-induced cardiomyopathy, with associated electrocardiographic changes, apical ballooning on echocardiogram, and elevated serum troponin levels. [53]

Seizures may be the result of acute cerebral hypoxia, but they may also be inciting events that lead to loss of consciousness and inability to protect the airway.


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