Patients usually develop autonomic dysreflexia one month to one year after their injury. However, it has also been described in the first days or weeks after the original trauma.
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 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 autonomic dysreflexia occur above T6?
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.
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)
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 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.
What is the classical signs of autonomic dysreflexia?
- A pounding headache.
- A flushed face and/or red blotches on the skin above the level of spinal injury.
- Sweating above the level of spinal injury.
- Nasal stuffiness.
- A slow heart rate (bradycardia).
- Goose bumps below the level of spinal injury.
- Cold, clammy skin below the level of spinal injury.
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.
What is the lowest level of spinal cord injury that autonomic dysreflexia could occur?
Autonomic dysreflexia (AD) is a condition of uncontrolled sympathetic response secondary to a precipitant, that generally occurs in patients with injury to the spinal cord at levels of T6 and above. AD is important on two accounts.
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.
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.
How quickly does autonomic dysreflexia occur?
Patients usually develop autonomic dysreflexia one month to one year after their injury. However, it has also been described in the first days or weeks after the original trauma. Objectively, an episode is defined as an increase in systolic blood pressure of 25 mm Hg.
Why is there sweating in autonomic dysreflexia?
Nonthermoregulatory reflex sweating is an indication of unchecked spinal cord facilitation and is precipitated by afferent stimuli from bladder, rectum, and various other sources. It is usually a manifestation of mass reflex or autonomic crisis and occurs particularly in cervical or high thoracic lesions.