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Research Paper | Physical Medicine and Rehabilitation | India | Volume 12 Issue 7, July 2023
A Study of Cardiac Autonomic Dysfunction in Patients with Traumatic Brain Injury
Dr. Ijaz N. Pillai | Dr. Kurian Zachariah | Dr. Sejil T. V.
Abstract: Background: Traumatic brain injury (TBI) is a leading cause of disability worldwide. Autonomic dysfunction presents clinically as Paroxysms of Autonomic Instability with Dystonia (PAID) and sub - clinically Heart Rate Variability abnormalities. This is a treatable contributor to secondary brain damage and disability after TBI. Objectives: To describe prevalence of clinical and subclinical cardiac autonomic dysfunction in patients with TBI and to look for its association with severity of brain injury and functional status. Methods: This was a cross sectional, observational descriptive study conducted on in - patient basis. Adult patients with TBI underwent the study. History, examination, functional assessment using Modified Barthel Index (MBI), Disability Rating Scale (DRS) and Glasgow Outcome Scale Extended (GOS - E) were recorded. Primary outcome measures were screening for PAID and Heart rate variability (HRV) measurement. Results: Among the 12 patients who underwent the study, 5 (41.67%) were noted to have PAID. All 5 belonged to severe TBI subgroup. On HRV assessment, in addition to the patients who had PAID, 4 patients were noted to have at least one parameter suggestive of sympathetic hyperactivity. Conclusion: The prevalence of PAID in TBI patients was found to higher than previous studies. This may be due to the increased number of severe TBI patients recruited for the study. Even in the absence of clinically evident dysautonomia, subclinical autonomic dysfunction is very common. This study hints at autonomic dysfunction to be a common, under - diagnosed sequalaeto TBI that could point towards a treatable cause of reduced functional recovery.
Keywords: MeSH, PAID, Paroxysmal Autonomic Instability with Dystonia, Dysautonomia, Hear rate variability, Brain Injury, Traumatic, Autonomic dysfunction
Edition: Volume 12 Issue 7, July 2023,
Pages: 134 - 138