A young client is comatose after a series of ischemic strokes. They have frequent painful episodes of paroxysmal sympathetic hyperactivity, during which their muscles become spastic and their heart rate and blood pressure rise. Their palliative care team wonders if massage therapy might help the contractures of their limbs, and the massage therapist is willing to try . . . but the results are unexpected.   Resources:   Neurostorming: Causes, Signs, Risks, and Treatment (2022) NewGait. Available at: https://thenewgait.com/blog/neurostorming/ (Accessed: 16 February 2024).   Paroxysmal sympathetic hyperactivity - UpToDate (no date). Available at: https://www.uptodate.com/contents/paroxysmal-sympathetic-hyperactivity (Accessed: 14 February 2024).   Zheng, R.-Z. et al. (2020) ‘Identification and Management of Paroxysmal Sympathetic Hyperactivity After Traumatic Brain Injury’, Frontiers in Neurology, 11, p. 81. Available at: https://doi.org/10.3389/fneur.2020.00081.   Verma, R., Giri, P. and Rizvi, I. (2015) ‘Paroxysmal sympathetic hyperactivity in neurological critical care’, Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine, 19(1), pp. 34–37. Available at: https://doi.org/10.4103/0972-5229.148638.   Xu, S., Zhang, Q. and Li, C. (2023) ‘Paroxysmal Sympathetic Hyperactivity After Acquired Brain Injury: An Integrative Review of Diagnostic and Management Challenges’, Neurology and Therapy, 13(1), pp. 11–20. Available at: https://doi.org/10.1007/s40120-023-00561-x.   Host Bio:                    Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist’s Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP’s partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner’s books are available at www.booksofdiscovery.com. And more information about her is available at www.ruthwerner.com.      Sponsors:     Books of Discovery: www.booksofdiscovery.com   Anatomy Trains: www.anatomytrains.com Elements Massage: www.elementsmassage.com/abmp MYCO CLINIC: www.myco-clinic.com   Anatomy Trains is a global leader in online anatomy education and also provides in-classroom certification programs for structural integration in the US, Canada, Australia, Europe, Japan, and China, as well as fresh-tissue cadaver dissection labs and weekend courses. The work of Anatomy Trains originated with founder Tom Myers, who mapped the human body into 13 myofascial meridians in his original book, currently in its fourth edition and translated into 12 languages. The principles of Anatomy Trains are used by osteopaths, physical therapists, bodyworkers, massage therapists, personal trainers, yoga, Pilates, Gyrotonics, and other body-minded manual therapists and movement professionals. Anatomy Trains inspires these practitioners to work with holistic anatomy in treating system-wide patterns to provide improved client outcomes in terms of structure and function.                      Website: anatomytrains.com                        Email: info@anatomytrains.com             Facebook: facebook.com/AnatomyTrains                       Instagram: www.instagram.com/anatomytrainsofficial   YouTube: https://www.youtube.com/channel/UC2g6TOEFrX4b-CigknssKHA       Founded by a massage therapist for massage therapists, the Elements Massage brand is a network of independently-owned and operated studios dedicated to changing lives--including yours!  The Elements Massage brand believes massage therapists deserve a supportive team, business and marketing resources, and the chance to learn as much as they want, so many Elements Massage studios offer and reimburse co