Abstract
The autonomic nervous system is affected in a wide variety of neurological disorders.
Its dysfunction may play an important role in the clinical course and may result in
serious complications, such as cardiac arrest. We report a case of tetanus who presented
with severe autonomic nervous system dysfunction which was detected by spectral analysis
of heart rate variability monitored over 24 h. This is a semi-quantitative method
for evaluation of the status of the autonomic nervous system. In the present case,
the analysis revealed profoundly decreased activity of both sympathetic and parasympathetic
nervous system modulation of cardiac rhythm. The parasympathetic nervous system activity
was more severely impaired than that of the sympathetic nervous system. The relative
predominance of the sympathetic nervous system in the present case may have resulted
in unopposed sympathetic nervous system hyperactivity manifested in this patient by
tachycardia and excessive sweating. We further infer that the documented diminished
buffering capacity of the autonomic nervous system may have lead to a sudden cardiac
arrest in our case. Thus, spectral analysis of heart rate variability is a non-invasive
and sensitive method for evaluating the status of the autonomic nervous system of
critically ill patients in the hospital setting.
Keywords
Abbreviations:
ANS, autonomic nervous systems (), SNS, sympathetic nervous systems (), PNS, parasympathetic nervous systems (), HRV, heart rate variability (), DTP, diphtheria, tetanus, and pertussis (), EEG, electroencephalogram (), ECG, electrocardiogram ()To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
August 1,
2001
Received in revised form:
July 13,
2001
Received:
March 15,
2001
Identification
Copyright
© 2001 Elsevier Science B.V. Published by Elsevier Inc. All rights reserved.
