Neurostorming: Causes, Signs, Risks, and Treatment


Individuals who have suffered a severe traumatic brain injury may go through a period of neurostorming.


Also called paroxysmal sympathetic hyperactivity, neurostorming is an acute and extreme stress reaction caused by brain injury. For instance, a person’s heart rate, blood pressure, or temperature may suddenly increase.



Comatose patients often experience neurostorming after sustaining a severe brain injury. People with brain injuries can overcome storming, regain consciousness, and fully recover with the help of medical professionals and time.


This article will address the causes, symptoms and treatment options you can explore.

What is Neurostorming?

If you’ve suffered head trauma, you may have neurostorming, a state characterized by an overactive sympathetic nervous system (SNS). The sympathetic nervous system (SNS) triggers the “fight or flight” reaction.


When triggered, the body goes into a state of heightened attention, raising the rate at which it performs essential processes like heart rate, blood pressure, and temperature regulation.



The ability to either “fight” or “flee” from a potentially harmful or stressful circumstance is what the “fight-or-flight” reaction is all about. When danger is no longer present, the body’s parasympathetic nervous system (PNS) takes over and causes a state of deep relaxation.


It does this by bringing the heart and respiratory rates back to normal.

However, the sympathetic response may become dysfunctional after a serious brain injury. The brain has been compromised. Therefore, it cannot assess whether or not the body is in danger correctly.


As a result, the sympathetic nervous system becomes more active, leading to the unwarranted release of adrenaline and other hormones into the bloodstream.



The stress reaction is beneficial in the short term, but too much of it can harm your health in the long run (which will be discussed later in this article).


Knowing the symptoms of a neurostorming episode and getting medical help quickly can prevent more severe consequences from developing.

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Neurostorming Symptoms and Signs

After sustaining a brain injury, the signs and symptoms of neurostorming might look very different depending on the individual. Neurostorming can last anywhere from a few hours to several months after an injury.



When someone has to storm due to a brain injury, they are typically in a coma and unaware of what is occurring to them. Therefore, it is helpful for loved ones and healthcare providers to be on the lookout for symptoms of neurostorming.


Symptoms of neurostorming are listed below;

  • Temperature more than 101 degrees (38.5 degrees Celsius).
  • Having an abnormally high blood pressure (hypertension)
  • If your heart rate is over 130 beats per minute, get medical attention immediately (tachycardia)
  • Tachypnea is characterized by a rapid breathing rate of more than 40 breaths per minute.
  • Sweating excessively (diaphoresis)
  • Stiff muscles in the arms and legs
  • Back-arched neck and spine and pointing toes (abnormal posturing)
  • Restlessness
  • Increased pupil size
  • Glycogenolysis
  • A higher resting metabolic rate

Causes of Neurostorming


Hydrocephalus, intracerebral haemorrhages, and hypoxic brain damage are all common outcomes of a storm. However, those who have suffered traumatic brain injuries are more likely to experience this. The neurological phenomenon known as “neurostorming” may occur in 15-33% of comatose individuals with severe traumatic brain injuries.


After a brain injury, most people’s storming episodes happen by themselves and without provocation. While there are many potential causes, some of the more common ones are:

  • Modifications to pharmaceutical regimens or the abrupt discontinuation of treatment
  • Repositioning
  • Stimulation from the environment (such as alarms or other loud noises)

Repercussions of Neurostorming

The effects of neurostorming can worsen a person’s health if they aren’t treated. The dangers of untreated neurostorming include:

  • Dehydration
  • Degeneration of muscle tissue
  • Weight loss
  • Pressure ulcers
  • Injury to the skeletal muscle

As was previously noted, neurostorming can cause considerable increases in one’s metabolic rate and core temperature, blood pressure, and muscle tone.


A person’s energy needs can increase by as much as 100% during a storming event. Muscle mass is lost along with fat when the metabolism is increased so dramatically.



It is more likely that pressure sores will form on people whose metabolisms are speeding up and who also perspire heavily. This can be extremely painful, put you at greater risk for infection, and severely restrict your range of motion.



Those with aberrant posturing for an extended period without treatment may also suffer irreversible musculoskeletal injury.


As a result, prompt and efficient treatment of neurostorming following brain injury is essential.



Drugs are typically used to treat secondary consequences of neurostorming, such as elevated blood pressure and fever. These pills are designed to calm the body and lessen the effects of stress. Potentially avoidable secondary effects of storming may be avoided if the indications and symptoms of a hyperactive sympathetic nervous system are managed.

Neurostorming medications include, but are not limited to, the following:

  • Opioids (morphine, fentanyl, etc.)
  • Medicines administered intravenously (propofol)
  • Beta-adrenergic antagonists (propranolol, metoprolol, etc.)
  • α2-agonists (clonidine, dexmedetomidine, etc.)
  • Benzodiazepines (diazepam, lorazepam, etc.)
  • Neuromodulators (gabapentin, baclofen)

The sudden discontinuation of a drug can trigger neurostorming. For this reason, it is best to taper off medications over time as the patient improves.

Increasing caloric, protein, and water consumption may also be part of the therapy plan to compensate for the high metabolism and lessen the likelihood of muscular atrophy and dehydration.

How to Avoid Neurostorming?

Intense mental agitation, known as “neurostorming”, can occur after a head injury. When neurostorming is prevalent, loved ones may worry that their relative or friend’s health is getting worse. Storming, however, is a typical response to a traumatic brain injury of sufficient severity.



Even still, many onlookers of a neurostorm report feeling helpless. Lucky for you, there are a few ways to pitch in: Learn something and share it with others. Recognize the symptoms of neurostorming following a brain injury (such as the ones listed above).



The nurses are on high alert. If you recognize the signs of neurostorming, you can call for help before the condition worsens. You should contact a nurse if you notice changes in your loved one’s temperature or heart rate.



Make sure you’re being proactive. At last, you have options for averting neurostorming. Effective techniques include speaking softly to them, rubbing their arms and legs, and using a cool cloth to reduce their body temperature.


Your loved one’s brain can still respond to stress even if unconscious. The room should be a peaceful retreat for them, so make an effort in that direction.



How to avoid neurostorming? Examine the causes and possible symptoms of neurostorming to protect your loved ones. Explore the treatment options for neurostorming recovery.



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