Incidence and clinical features of autonomic dysreflexia in patients with spinal cord injury

Abstract

Abstract. The histories of 444 patients admitted to this spinal cord injury service were reviewed for the incidence of autonomic dysreftexia (A.D.). Forty-eight per cent of 21 3 patients with complete cord lesions at T6 or above exhibited A.D. The time of onset post-injury, exciting causes, unusual manifestations of attacks, and the persistence of the condition were studied. These findings and the experience with attempts at prevention by education and by the use of an alpha-adrenergic blocker and a non-adrenergic vaso dilating agent are reported.

Autonomic hyperreflexia associated with recurrent cardiac arrest: Case Report

“…1,4 ± 6 Heightened sympathetic activity associated with hypertensive crisis during an episode have resulted in seizures, 3,4,6 retinal 4 and intracranial hemorrhages, 3 cerebral vascular accidents, 3,8 coma 3,6 and death. 3,6 Resolution of this autonomic phenomenon occurs with removal of the noxious stimulus precipitating the event.…”

“…1 ± 3 The heightened sympathetic activity during an episode of autonomic hyperre¯exia accounts for several of the clinical features commonly observed including sudomotor and pilomotor phenomenon, 1,4 ± 6 vasomotor sequelae, 1 ± 4,7 and alterations in cardiac inotropic and chronotropic activity. 1,2,4,6,7 Cardiac abnormalities described in association with episodes of autonomic hyperre¯exia include bradycardia 1,4,6,7 and tachycardia, 2,6,7 premature atrial and ventricular contractions, 1,8 atrial ®brillation 9,10 and conduction block. 8 Despite the occurrence of these arrhythmias associated with autonomic hyperre¯exia, they are seldom recognized as a cause of cardiac arrest in individuals with traumatic spinal cord injury.…”

Neuropathic lumbar spondylolisthesis – a rare trigger for posture induced autonomic dysreflexia

“…A variety of stimuli induce dysre¯exic symptoms, though the commonest is probably bladder distension. 3,4 The impulse from the stimulus travels to the spinal cord and then in a cranial direction in the lateral spinal thalamic tracts and dorsal columns. This precipitates a massive uninhibited sympathetic response through the intermediolateral cell column.…”

Recurrent dislocation of the hip in adult paraplegics

“…This was due to autonomic dysreflexia, a syndrome which can occur in patients with high thoracic or with a cervical cord injury. 9 It is normally triggered by noxious stimuli. These unpleasant symp toms were quite disabling and worrying for the patients.…”