Brainstorming in neuro pt

CRNI-ICU20 · Mar 5, 2007

Hi...

Are you talking about "locked in syndrome?".....

Psuedo-seizures?

Was this a patient who had brain injury or tumor?

need more information....

nurseguinness · Mar 5, 2007

Yes it is usually TBI with brainswelling. I think they may refer to it as psuedoseizures. But the Neuro docs in Houston call it brainstorming. Usually they go tachy, and their temp is uncontrollable.

meandragonbrett · Mar 6, 2007

Yes, it commonly happens in post-neuro injury. There was an article about it in the Feb 2007's issue of Critical Care Nurse. They refered to it as "Sympathetic Storming" S/sx include fever, posturing, tachycardia, HTN, and diaphoresis. Can happen anywhere from 24hours -2 weeks post injury. Mechanism for this sympathetic response is not currently known.

Do a google search for "Sympathetic Storming" and I'm sure you can get tons of information. You could also check out Google Scholar to get journal articles.

nurseguinness · Mar 7, 2007

Thanks for your help. I will start searching.

subee, MSN, CRNA · Mar 16, 2007

Yes, it commonly happens in post-neuro injury. There was an article about it in the Feb 2007's issue of Critical Care Nurse. They refered to it as "Sympathetic Storming" S/sx include fever, posturing, tachycardia, HTN, and diaphoresis. Can happen anywhere from 24hours -2 weeks post injury. Mechanism for this sympathetic response is not currently known.
Do a google search for "Sympathetic Storming" and I'm sure you can get tons of information. You could also check out Google Scholar to get journal articles.

This sympathetic storming occurs during the dying process also where large amounts of norepi and even seretonin are released.

AllYsa1707 · Mar 30, 2007

i worked in a general icu where we would occassionally admit neuro/head injury patient. please enlighten me with this..i have encountered a patient with post head injury kick from a horse ...all ct scans showed NAD but after three days post extubation patient develop a severe headache and manifest "seizure " like activity.after the seizure it took a while for the patient to regain consciousness..then she complained of sensitivity to light..but during all these episodes there was no changes on the heart rate and even no elevation/drop of blood pressure..was relieve when df118 was given.i hate to say if she was faking it...

gasmaster · Apr 11, 2007

ALLYsa, sounds like a fake to me. There is always a sympathetic response to seizure (>HR, peripheral constriction, pupil dilation, sometimes diaphoresis). It can't be helped; it's just part of the process. Many pseudo-seizure pt's are SO good at faking that they illicit a SNS response. Could be that your patient was pseudo....sounds weird though. Any psych hx?

AllYsa1707 · Apr 18, 2007

funny you asked...not realy diagnosed but it seems she was known to general ward where she would be in terrible pain and would ask for all kinds of pain relief....and eventually there was nothing sinister with her seizure activity...she was really faking it....

she really got the ignorance in us...

:uhoh3:

gasmaster · Apr 18, 2007

Nah, no ignorance. Once in a blue moon there's a real seizure with no SNS response, etc. It's rare but can happen. There are even "seizure" pt's who have normal EEG's, again rare but does happen. :banghead: Drive ya crazy...doesn't it?

LionNurse · Jun 3, 2012

The patient i work for had a traumatic brain injury 5 years ago and goes though 'storming' everyday, still. HR 185, Decreased O2, Sweating, Spasms, Muscles Tightening up, Contractures...He has at least one a day, and sometimes when he gets sick it triggers a full on storming session that has lasted up to 25 hours.

umcRN, BSN, RN · Jun 5, 2012

we call it "neuro-storming" here. I have seen it once in a baby who had a severe hypoxic brain injury after prolonged cardiac arrest and resuscitation (i believe it lasted about 2 hours and he received approx 11 doses of EPI). Months after this event he lives in a constant storm. His mother refuses many medications that will stop the storming and he is constantly posturing, desatting, hypertensive, he is heartbreaking to see. As someone who knew him before the event I had a difficult time caring for him. He was trach/vent dependent before this code so he is in and out of the hospital with his family still holding hope for a recovery. It's absolutely distressing to witness but EEG's/neuro have confirmed that he is not seizing though that is what it looks like, unfortunately his family refuses most of the medications to stop the storming.