Introduction:

paroxysmal sympathetic hyperactivity (PSH) is a complication that consists of increased sympathetic activity, which occurs in 10 to 30% of patients treated in intensive care for brain injury. In this paper, we describe the clinical course of three Mexican children who developed PSH.

Case presentation:

three patients younger than five years-old who, after the acute phase of a serious neurological event, developed cardiovascular symptoms (tachycardia, hypertension and fever) and dystonia. When other entities were excluded, the diagnosis of paroxysmal sympathetic hyperactivity was integrated. By ruling out other entities, the diagnosis of PSH was integrated. Management consisted of antihypertensive agents and muscle relaxants, but several weeks were required to achieve improvement.

Conclusion:

PSH is a complication that delays the evolution and recovery of patients who have brain injury and are in critical condition. Its identification is important for its timely management.