After a sports injury, slip and fall, or car accident, we are prone to worry about extremity personal injuries, including broken legs or arms, bone fractures, and lacerations as these can be the most noticeable and, often, most painful. However, when arriving at the emergency department, doctors will first check vital signs and test for symptoms of neurologic impairment for fear of traumatic brain injury (TBI). If left untreated, TBIs can cause detrimental injury to the brain and nervous system, but even with immediate treatment, TBIs can result in patients being comatose. A sequela, or secondary, related injury, of TBIs is neurostorming – a jarring reaction by the sympathetic nervous system in a comatose patient.
Definition of Neurostorming
Neurostorming is a hyperactive response of the sympathetic nervous system – the division of the nervous system controlling response to environmental changes and stress. In comatose patients who have suffered a TBI, it is common for patients to remain stuck in a ‘fight-or-flight’ response due to brain trauma. The ‘fight-or-flight’ response is triggered by the sympathetic nervous system, so damage to the brain can leave this response ‘on’ for days, weeks, and even months. In this type of response, blood pressure is elevated, adrenaline production is increased, and the body requires a higher amount of energy to operate. Essentially, patients experiencing neurostorming are in an intense, elevated reaction to their environment without there being a threat to them. They are unaware of their reaction and are unable to turn it off as their brain injury makes this impossible. Even outside of comatose TBI patients, many comatose patients being rolled to prevent pressure sores, patients changing medications, or patients being exposed to loud stimuli can enter a neurostorming phase and must be treated for such.
Symptoms of Neurostorming
Most patients who have a neurostorming response have experienced TBI and are in an unconscious state, like a coma. Physical symptoms of neurostorming include:
- high-grade fever
- high blood pressure
- high heart rate
- rapid breathing
- rigid muscles.
In lab testing, physicians find an increased release of glucose and increased basal metabolic rate. This is all due to the ‘fight-or-flight’ response. If we think to when we are scared, perhaps at a haunted house for Halloween, our muscles are rigid, hearts racing, and ready to run away from the danger we perceive as real. Similarly, patients experiencing neurostorming are in the same position, but they are in no apparent danger and are unable to ‘snap’ out of this response.
How to Help Manage Neurostorming Symptoms
When a patient is in a comatose state, highly trained medical professionals will provide 24/7 care and will know how to properly treat their symptoms. Common treatments for neurostorming are medications that slow the body’s stress response, which includes opioids, IV anesthetics, benzodiazepines, neuromodulators, and other related medications. For family members taking care of patients with TBI, keeping a careful eye on them for signs of neurostorming symptoms and immediately acting if they arise is key. When a patient is experiencing neurostorming, tracking their caloric and water intake is important as muscle atrophy and dehydration are some of the first adverse effects of neurostorming to arise, yet they are some of the easiest to treat.
Are You or a Family Member Suffering From a TBI? We can help.
If your loved one is currently experiencing or experienced a traumatic brain injury and neurostorming following an accident, contact The Simon Law Firm, P.C. today for a free, confidential consultation. TBI and neurostorming are difficult injuries to experience as a patient, but also for the family supporting them. Our supportive TBI-focused team will listen to your family’s story, determine how to best move forward, and hold the appropriate people accountable for your family member’s injury.