More than half of people with a spinal cord injury in the upper back get it. Autonomic dysreflexia is an emergency and needs immediate medical attention. It can be life-threatening. You can get autonomic dysreflexia
if you’ve injured your spinal cord around the bottom of the shoulder blades or above
.
What is the most common cause of autonomic dysreflexia?
The most common cause of autonomic dysreflexia (AD) is
spinal cord injury
. The nervous system of people with AD over-responds to the types of stimulation that do not bother healthy people.
Who is most at risk for autonomic dysreflexia?
Autonomic dysreflexia is a condition that emerges after a spinal cord injury, usually when the injury has occurred above the T6 level. The higher the level of the spinal cord injury, the greater the risk with up to 90% of
patients with cervical spinal or high-thoracic spinal cord injury
being susceptible.
What triggers autonomic dysreflexia?
Autonomic dysreflexia can occur on a daily basis and can be triggered by stimuli such as
distension of the bladder (most common)
, bladder or kidney stones, a kink in a urinary catheter, infection of the urinary tract, fecal impaction, pressure sores, an ingrown toenail, fractures, menstruation, hemorrhoids, invasive …
Why does T6 cause autonomic dysreflexia?
Patients with lesions above T6 are most susceptible to autonomic dysreflexia
because the large splanchnic blood vessels are supplied by sympathetic fibres carried within T6 to T10 nerve roots
.
What does Dysreflexia mean?
Topic Overview. Autonomic dysreflexia is
a syndrome in which there is a sudden onset of excessively high blood pressure
. It is more common in people with spinal cord injuries that involve the thoracic nerves of the spine or above (T6 or above).
What is the emergency treatment for autonomic dysreflexia?
The most commonly used agents are
nifedipine and nitrates (eg, nitroglycerine paste or sublingual nitroglycerine)
. Nifedipine should be in the immediate-release form; bite and swallow is the preferred method of administering the drug, not sublingual administration.
Can a paralyzed man still get erect?
Most paralyzed men are able to have a
reflex erection with physical stimulation unless the S2–S4 pathway is damaged
. Spasticity is known to interfere with sexual activity in some people with SCI.
What is silent autonomic dysreflexia?
SILENT AUTONOMIC DYSREFLEXIA
Current research shows that
significant elevations in blood pressure can occur without signs and symptoms of AD (asymptomatic)
. This condition is known as “Silent” Autonomic Dysreflexia.
How often does autonomic dysreflexia occur?
Autonomic dysreflexia can occur in susceptible individuals
up to 40 times per day
.
What would happen if autonomic dysreflexia is left untreated?
If left untreated, autonomic dysreflexia can cause
seizures, retinal hemorrhage, pulmonary edema, renal insufficiency, myocardial infarction, cerebral hemorrhage
, and, ultimately, death. Complications associated with autonomic dysreflexia result directly from sustained, severe peripheral hypertension.
Does autonomic dysreflexia go away?
Your body cannot restore your blood pressure to
normal
because of your spinal cord damage. The only way to return things to normal is to change the situation—for example, by removing tight clothing or emptying your bladder.
What type of doctor treats autonomic dysreflexia?
Physicians specializing in physical medicine and rehabilitation
are well-acquainted with the diagnosis and management of autonomic dysreflexia and can be of assistance in both acute management and prevention strategies of this syndrome.
What nerves are affected by T6?
T-6 through T-12 nerves affect
abdominal and back muscles
. These nerves and muscles are important for balance and posture, and they help you cough or expel foreign matter from your airway.
Which are characteristics of autonomic dysreflexia?
In autonomic dysreflexia, patients will experience
hypertension, sweating, spasms (sometimes severe spasms)
and erythema (more likely in upper extremities) and may suffer from headaches and blurred vision.
Can a UTI cause autonomic dysreflexia?
The common stimulus for autonomic dysreflexia is
bladder and rectal distension
, but it can also be precipitated by urinary tract infection (as in our case), deep venous thrombosis, ingrown toenail, insect bite, burns, contact with sharp object, splints, skin irritants, hot or cold stimuli, dysmenorrhea, pregnancy, …
