Hypotonic-Hyporesponsive Episode (HHE, Shock-Like Syndrome)

Hypotonic-Hyporesponsive Episode
Body Parts: Whole Body
Medical Subjects: Children's Health Nervous System

What Is Hypotonic-hyporesponsive Episode?

Hypotonic-hyporesponsive episode is a severe immune response that occurs after vaccination as a shock-like lesion with reduced muscle tension, microcirculation disorders, cold limbs, and pale face and body.


What Is The Cause Of Hypotonic-hyporesponsive Episode?

What caused the hypotonic-hyporesponsive episode?

It is mainly a relatively rare complication after vaccination against diphtheria, tetanus and pertussis. The pathogenesis is unknown and may be related to allergies or hypoglycemia. There are also hypotheses that activation of inflammatory pathways may play a role in eventually causing autonomic nervous system activity.

Who are the most susceptible to hypotonic-hyporesponsive episode?

It is more common in children and is mainly related to vaccination of children under 2 years of age with whooping cough. It often occurs in infants.


What Are The Symptoms Of Hypotonic-hyporesponsive Episode?

A sudden reaction, usually within 48 hours (usually within 12 hours) after receiving the DPT vaccine and lasting from one minute to several hours, can occur slowly or progress rapidly.

Manifestations include pale skin, lethargy or lethargy, irritability or continuous screaming, anorexia or inability to suck, silent crying, excessive oral and nasal discharge, indifferent reaction, and even loss of consciousness in serious cases, cyanosis in complexion, lips or limbs, low body temperature, cold and wet as well as soft or weak limbs. Physical examination shows that pupils are insensitive to light reflection. About 0.2% of children can suddenly collapse, continue to scream, significant neurological changes, and even death.


How To Check Hypotonic-hyporesponsive Episode?

The absence of specific diagnostic criteria is based primarily on the presence of symptoms within a few hours of vaccination and requires all of the following: weakness (hypotonia), dysfunction (hyporesponsiveness), pallor or cyanosis, loss of attention or memory.

Further monitoring of vital signs such as respiration, heart rate and blood pressure is required, and a comprehensive physical examination is required. Particular attention is paid to neurological signs, and blood glucose is monitored. Routine examinations such as hematuria and feces, C-reactive protein, procalcitonin, cardiac color Dopplar ultrasound, chest X-ray, head CT or magnetic resonance, and cerebrospinal fluid test are conducted according to the situation, to exclude relevant diseases such as nervous system, circulatory system and respiratory system, and infection and poisoning.


How To Treat Hypotonic-hyporesponsive Episode?

The attack is transient and self-limited, and symptomatic treatment is given priority to. It is not a contraindication for further immunization.

Severe symptoms need anti-allergic treatment, and completes the symptomatic support treatment and basic nursing care, monitoring of vital signs, clean up the airway, keep respiratory tract patency, oxygen, intravenous infusion to maintain stable circulation, keep warm and improve microcirculation, prevent lung drop product and infection, etc.

The prognosis of this disease is good and there is no risk of sequelae. Very few patients with severe symptoms may die if the treatment is not timely.

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