Seesaw dysautonomia: A manifestation of autonomic dysreflexia

Wu, Helen Zong Ying; Ahmad, Kate; Tan, Kimberley; Blair, Nicholas F.

doi:10.1212/wnl.0000000000001022

Cited by 2 publications

(6 citation statements)

References 6 publications

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“…As the patient's bladder was emptied the symptoms resolved. A similar case by Wu et al 2 reported a patient with incomplete tetraplegia who was found to have alternating anisocoria in response to noxious stimuli below the level of injury. This too was suggestive of autonomic dysfunction and the phenomenon Figure 1 Sympathetic innervation of the eye.…”

Section: Conclusion/clinical Relevancementioning

confidence: 73%

“…To our knowledge, only two case reports discuss transient anisocoria after a cervical SCI. 1,2 Cragg et al, 1 reviewed a case where a patient with complete tetraplegia was found to have left-sided facial flushing and diaphoresis with contralateral miosis and anhydrosis, suggestive of a right-sided Horner's syndrome. These symptoms occurred simultaneously with a rise in systolic BP 150 mmHg above the patient's baseline.…”

Section: Conclusion/clinical Relevancementioning

confidence: 99%

“…Hypotheses regarding the pathophysiology have been previously described. 1,2 One proposed mechanism described an asymmetric increase in intramedullary pressure with a concomitant increase of intrasyrinx pressure within the spinal cord that selectively compromised sympathetic output and caused Horner Syndrome. 1 The second case report added that a contralateral noxious stimulus was often the culprit of the contralateral pupillary dilation and hyperhidrosis, understood by a previous mechanism caused by the decussation of afferent spinothalamic pathways within the spinal cord.…”

Section: Conclusion/clinical Relevancementioning

confidence: 99%

“…Anisocoria is a medical condition that is considerably influenced by the autonomic nervous system and is characterized by a difference in pupil size. 1,2 The autonomic nervous system regulates whole body homeostasis through complex sympathetic and parasympathetic pathways. Interruption to the pathways of the sympathetic nervous system can lead to autonomic dysreflexia, a life-threatening condition reported in individuals with injuries above T6 (however, it can sometimes occur lower).…”

Section: Introductionmentioning

confidence: 99%

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Transient anisocoria after a traumatic cervical spinal cord injury: A case report

Overdorf

Farkas

Romanoski

2018

The Journal of Spinal Cord Medicine

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Context: Autonomic dysreflexia and dysautonomia can be a common complication following spinal cord injury, especially at levels of T6 and above and can lead to complications associated with the pupil. In this case report, we review autonomic dysreflexia, the anatomy and physiology of the sympathetic nervous system of the eye, as well as review the clinical relevance in understanding autonomic and pupillary changes in response to autonomic dysfunction. Findings: We present a patient with an incomplete C4 level injury who was found to have isolated anisocoria on two separate occasions during his acute inpatient rehabilitation stay. Conclusion/Clinical Relevance: Anisocoria associated with abnormal sympathetic activation may be a clinical sign of dysautonomia.

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Section: Conclusion/clinical Relevancementioning

confidence: 73%

Section: Conclusion/clinical Relevancementioning

confidence: 99%

Section: Conclusion/clinical Relevancementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Transient anisocoria after a traumatic cervical spinal cord injury: A case report

Overdorf

Farkas

Romanoski

2018

The Journal of Spinal Cord Medicine

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“…It may be related to metabolism, pain, and stress. The researchers proposed the term "seesaw dysautonomia" [7] to describe this phenomenon.…”

Section: Discussionmentioning

confidence: 99%

Rare autonomic nervous system dysfunction: Alternating bilateral mydriasis

Xu¹,

Wu²,

Su³

et al. 2021

World Journal of Emergency Medicine

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This study did not receive any funding. Ethical approval: The research was approved by the hospital ethics committee. Conflicts of interests:The authors declare that they have no competing interests. Contributors: PX, JW, and LDS analyzed and interpreted the patient data regarding autonomic nervous system dysfunction. FQ, HQW, YY, and ML performed the specialized examination and imaging analysis of the patient, and were major contributors in writing the manuscript. YHH and MH checked and revised the paper. All authors have read and approved the fi nal manuscript.

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Seesaw dysautonomia: A manifestation of autonomic dysreflexia

Cited by 2 publications

References 6 publications

Transient anisocoria after a traumatic cervical spinal cord injury: A case report

Transient anisocoria after a traumatic cervical spinal cord injury: A case report

Rare autonomic nervous system dysfunction: Alternating bilateral mydriasis

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