Autonomic hyperreflexia occurs in up to 85 percent of individuals with spinal cord injuries above the major splanchnic sympathetic outflow. In such cases, paroxysmal reflex sympathetic activity develops in response to noxious stimuli below the level of the neurologic lesion.
What is hyperreflexia in spinal cord injury?
Autonomic hyperreflexia (AHR) is a potentially life-threatening hypertensive condition that develops in up to 85 % of patients with spinal cord injury (SCI) above the splanchnic outflow, usually above the level of T6 [1–4].
How does spinal cord injury affect reflexes?
Spinal cord injuries first change the reflexes that occur in the nearest segment of the injury, then change the reflexes more distal away from the injured segment. Thus, high-level cervical injuries may have a longer preservation of sacral reflexes such as preserved bulbocavernosus and anal reflex.
How does autonomic dysreflexia occur with spinal cord injury?
Autonomic dysreflexia occurs when something happens to your body below the level of your injury. This can be a pain or irritant (such as tight clothing or something pinching your skin) or a normal function that your body may not notice (such as having a full bladder and needing to urinate).
What causes hyperreflexia?
Common disorders that manifest detrusor hyperreflexia are stroke, Parkinson’s disease, dementia, spinal cord injury, and multiple sclerosis. The cause of detrusor instability is much more difficult to identify and, therefore, it is most commonly considered idiopathic.
What is considered hyperreflexia?
Hyperreflexia refers to hyperactive or repeating (clonic) reflexes. These usually indicate an interruption of corticospinal and other descending pathways that influence the reflex arc due to a suprasegmental lesion, that is, a lesion above the level of the spinal reflex pathways.
Does a spinal cord injury shorten your life?
Life expectancy depends on the severity of the injury, where on the spine the injury occurs and age. Life expectancy after injury ranges from 1.5 years for a ventilator-dependent patient older than 60 to 52.6 years for a 20-year-old patient with preserved motor function.
Can you fully recover from a spinal cord injury?
In very rare cases, people with spinal cord injury will regain some functioning years after the injury. However, only a small fraction of individuals sustaining a spinal cord injury recover all function.
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.
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.
How do you test for autonomic dysreflexia?
Tests may include:
- Blood and urine tests.
- CT or MRI scan.
- ECG (measurement of the heart’s electrical activity)
- Lumbar puncture.
- Tilt-table testing (testing of blood pressure as the body position changes)
- Toxicology screening (tests for any drugs, including medicines, in your bloodstream)
Can hyperreflexia go away?
Recovery of hyperreflexia can occur between several hours to several months after a spinal cord injury; however, the phase of recovery is likely to occur in stages rather than on a continuum. The late stage can be defined as between two weeks and several months.
How do you treat hyperreflexia?
- moving you into sitting position to cause the blood to flow to your feet.
- removing tight clothes and socks.
- checking for a blocked catheter.
- draining a distended bladder with a catheter.
- removing any other potential triggers, such as drafts of air blowing on you or objects touching your skin.
What causes Hyporeflexia or hyperreflexia?
Hyporeflexia is generally associated with a lower motor neuron deficit (at the alpha motor neurons from spinal cord to muscle), whereas hyperreflexia is often attributed to upper motor neuron lesions (along the long, motor tracts from the brain).