Autonomic Hyperreflexia

Abstract

Autonomic hyperreflexia is a dramatic complication of injuries to the spinal cord above the sixth thoracic vertebra. Knowledge of the pathogenesis and specific treatment measures are essential to develop a rational plan of nursing intervention. At the time of the original publication, the author was director of nursing, Rehabilitation Institute of Detroit, and a member of the adjunct faculty at Wayne State University, College of Nursing. Previous to that, she had been a nurse specialist in rehabilitation with the responsibility for directing and providing a continuity of nursing care for spinal cord injured patients.

Assessing and conceptualizing orgasm after a spinal cord injury

“…Ejaculation is indeed associated with increases in SBP which satisfy the definition of AHR (SBP > 20 mmHg) and which can vary from 40 to 60 mmHg [6,47]. The changes in SBP are also accompanied in able‐bodied men by autonomic responses such as tachycardia, hyperventilation, hot flushes and red spot skin, all of which satisfy both the definition of AHR [28–33] and the description of orgasm [1–10]. In contrast to men with SCI, however, able‐bodied men show a rapid decrease in SBP, which returns to baseline within 2 min after ejaculation.…”

“…Men with SCI have a higher SBP at ejaculation, but this can last up to 20 min after ejaculation [37], which suggests that the loss of supraspinal inhibition maintains the autonomic hyperactivity and renders the climactic experience a more variable event. Indeed ejaculation is known to be a source of AHR in men with SCI [29–33] and its expression is known to vary along a continuum ranging from absent or mild AHR (especially in lower lesions) to moderate or severe AHR (especially in higher lesions) [28,34,35], which characterizes the quality and intensity of their climactic experience [4,28].…”

“…Autonomic hyperreflexia is a clinical condition that is primarily defined by an increase in systolic blood pressure (SBP) of at least 20 mmHg [29–33]. While the primary criterion for AHR is hypertension [34–36], it is also accompanied by perceived signs of autonomic arousal (e.g.…”

“…While the primary criterion for AHR is hypertension [34–36], it is also accompanied by perceived signs of autonomic arousal (e.g. goose bumps, hot flushes and sweating), tachycardia (or bradycardia in higher lesions) and increased spasticity or body spasms [28–33].…”

Percutaneous endoscopic sigmoid colostomy for irrigation in the management of bowel dysfunction of adults with central neurologic disease

“…However, it is cumbersome and messy, requiring up to 1.5 l of irrigation and carrying risks such as autonomic hyperreflexia [14] and rectal perforation. Patients also may not be able to insert the catheter themselves and thus cannot be independent.…”