Repetitive hyperbaric oxygen therapy for paroxysmal sympathetic hyperactivity after acute carbon monoxide poisoning

Delayed neuropsychological sequelae (DNS) are relatively common complications of acute carbon monoxide (CO)poisoning, and usually develop within several days to weeks after the initial clinical recovery from acute CO poisoning. DNS can consist of various symptoms such as memory loss, confusion, ataxia, seizures, urinary incontinence, fecal incontinence, emotional lability, disorientation, hallucinations, mutism, cortical blindness, psychosis, parkinsonism, gait disturbances, rigidity, bradykinesia, and other motor disturbances. Paroxysmal sympathetic hyperactivity (PSH) is a potentially life-threatening disease secondary to acute acquired brain injury. It is characterized by episodic and simultaneous paroxysmal increases in sympathetic and motor activities, not rare in patients with a severe traumatic brain injury. The term PSH is clinically more accurate than the previously used ones describing such conditions as non-stimulated tachycardia, hypertension, tachypnea, hyperthermia, external posturing, diaphoresis, and paroxysmal autonomic instability with dystonia. Development of PSH typically prolongs the length of hospital stay and potentially leads to a secondary brain injury or e