Bromocriptine for the management of autonomic dysfunction after severe traumatic brain injury

Russo, Rosa; O'Flaherty, Stephen

doi:10.1046/j.1440-1754.2000.00485.x

Cited by 57 publications

(38 citation statements)

References 24 publications

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“…These dystonic movements, if not managed in a timely manner, can result in generalised motor rigidity and pose difficulties during supportive nursing care in the ICU. A search of the literature showed that various drugs such as morphine, (1,6) a or b blockers, (3,9,10) dopamine agonists (6,7,13) and benzodiazepines (3,14) could be used to alter central nervous system responsiveness by virtue of changes to a, b, GABA, dopamine or opiate receptors, respectively. As the dystonic movements subsided in our patient when intermittent boluses of IV midazolam were given, continuous IV infusion of midazolam along with morphine was administered to control the abnormal movements, with good results.…”

Section: Discussionmentioning

confidence: 99%

Paroxysmal autonomic instability with dystonia (PAID) syndrome following cardiac arrest

Kapoor¹,

Singla²,

Singh³

et al. 2014

smedj

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Section: Discussionmentioning

confidence: 99%

Paroxysmal autonomic instability with dystonia (PAID) syndrome following cardiac arrest

Kapoor¹,

Singla²,

Singh³

et al. 2014

smedj

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“…It acts on the corpus striatum and the hypothalamus [29]. It may help in PSH, due to its action on dopaminergic transmission [30] [31]. Unfortunately, there is no a lot of studies on the efficacy of bromocriptine in traumatic brain injury [32].…”

Section: Discussionmentioning

confidence: 99%

Bromocriptine in Central Hyperthermia after Severe Traumatic Brain Injury

Zakhary¹,

Sabry²

2017

OJEM

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Strong evidence showed that fever after traumatic brain injury TBI is associated with increased mortality. In this study, we tried to evaluate the role of Bromocriptine in central hyperthermia in patients with severe TBI. This prospective controlled study was conducted on 50 severe TBI patients who admitted to the critical care department and confirmed on Computed Tomography (CT) of the brain and GCS of less than 9 at admission. Then, they were randomly assigned into 2 groups. Bromocriptine group (25) received bromocriptine 7.5 mg/day during 24 hours from admission through a naso-gastric (NG) feeding tube. Control group (25) received conventional treatment only. Temperature was measured every 2 hours. The antipyretic measures used were the same across all patients enrolled. The primary outcome was number of patients diagnosed with central hyperthermia. After the discharge of all patients, there was a statistically significant difference between the 2 groups in number of patients diagnosed with central hyperthermia (6 (24%) in bromocriptine group Vs 18 (72%) in control, p = 0.002). There were no differences in hospital length of stay (p = 0.904) or mortality (p = 0.393). Early administration of bromocriptine in severe TBI may be associated with lower incidence of central hyperthermia with no effect on length of stay or mortality.

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“…Studies have shown that neuroleptic malignant syndrome is caused by dopamine blockade, but the role of dopamine in the pathophysiology of PSH remains unclear. Bromocriptine is reported to be effective for PSH, and the efficacy is enhanced if used in combination with other medicines, especially morphine [27,38]. The effect of bromocriptine is modest and delayed.…”

Section: Dopamine Agonists and Antagonistsmentioning

confidence: 99%

Treatment Progress of Paroxysmal Sympathetic Hyperactivity after Acquired Brain Injury

Feng

Zheng

Fang³

2015

Pediatr Neurosurg

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Paroxysmal sympathetic hyperactivity (PSH) is a common complication of various acquired brain injuries such as traumatic brain injury, subarachnoid hemorrhage, anoxic brain injury, intracerebral hemorrhage, and others. It is manifested by tachycardia, hypertension, tachypnea, diaphoresis, and dystonic posturing. The development of PSH can prolong hospitalization and lead to secondary brain injury and even death. Despite the awareness of the serious clinical impact, there is no consensus on diagnostic criteria. Thus, misdiagnosis and delayed recognition is very common. Most of the current treatment programs come from case reports and small case series; there are very few large-scale randomized controlled trials. Generally accepted medications are opioids, β-blockers and gabapentin (usually used in combination). However, the efficacy of these drugs has not been systematically assessed. The purpose of this review is to determine the treatment strategies and drugs commonly used for PSH at the overall level.

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Bromocriptine for the management of autonomic dysfunction after severe traumatic brain injury

Cited by 57 publications

References 24 publications

Paroxysmal autonomic instability with dystonia (PAID) syndrome following cardiac arrest

Paroxysmal autonomic instability with dystonia (PAID) syndrome following cardiac arrest

Bromocriptine in Central Hyperthermia after Severe Traumatic Brain Injury

Treatment Progress of Paroxysmal Sympathetic Hyperactivity after Acquired Brain Injury

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