PAROXYSMAL SYMPATHETIC STORMS (DIENCEPHALIC SEIZURES) AFTER SEVERE DIFFUSE AXONAL HEAD-INJURY

We describe a patient with a se,ere traumatic head injury who exhibite d paroxysmal sympathetic storms, similar to those described in ''dienc ephalic seizures.'' No epileptiform activity was evident on electroenc ephalography, and therapeutic levels of anticonvulsants failed to alte r the spells; however, use of morphine sulfate abolished them, The fea tures of this and several previously reported cases refute the primary roles of the diencephalon and seizures in this syndrome, Rather, in t he setting of already! compromised autonomic neuronal integrity, subtl e fluctuations in intraventricular pressure or activation of reflexes triggered from muscle mechanoreceptors or chemoreceptors during episod es of hypertonia are more likely.;, ''Paroxysmal sympathetic storms,'' a more appropriate descriptive,le term for these phenomena, should be recognized; thus, unnecessary diagnostic evaluations can be minimized , and appropriate therapy can be initiated,.