MASTERCLASS: Understanding Paroxysmal Sympathetic Hyperactivity in Neurocritical Care

In this episode of the NCS Podcast Masterclass series, hosts Jon Rosenberg, MD, and Stephan Mayer, MD, speak with Jamie Podell, MD, assistant professor of neurocritical care and emergency medicine at the University of Maryland School of Medicine. Together, they explore paroxysmal sympathetic hyperactivity – how it develops after brain injury, why symptoms differ among patients and what current research suggests about its underlying neural networks. Dr. Podell offers practical guidance on recognizing patterns, avoiding anchoring bias and distinguishing PSH from other causes of instability. The conversation also covers common treatment approaches, scoring tools used at the bedside and areas of ongoing study. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.