Neurogenic Fevers: Pattern and Characteristics

Definition and Characteristics

• Neurogenic fever is defined as core temperature >37.5°C driven by neurological dysregulation without evidence of sepsis or clinically significant inflammatory processes 1, 3
• It is a relatively common complication in patients with traumatic brain injury (TBI) and other neurological injuries 1

Pattern of Neurogenic Fever

• Unlike some other fever syndromes, neurogenic fevers typically present as persistent temperature elevations without a cyclic pattern 4

Contrasting with Cyclic Fever Patterns

• Adult-Onset Still's Disease presents with quotidian (daily) fever spikes, typically in the evening 4, 5
• Familial Mediterranean Fever shows self-limited episodes lasting 1-3 days rather than the persistent pattern of neurogenic fever 4
• TRAPS (TNF receptor associated periodic syndrome) has longer fever attacks averaging 21 days 4

Clinical Implications and Management

• Uncontrolled neurogenic fever can precipitate secondary brain injury in patients with neurological conditions 1, 3
• Management recommendations include prompt detection and treatment with controlled normothermia targeting 36.0-37.5°C 1, 3