What is Autonomic dysreflexia?

Autonomic dysreflexia (AD) is a condition that can occur in anyone who has a spinal cord injury at or above the T6 level. It is related to disconnections between the body below the injury and the control mechanisms for blood pressure and heart function. It causes the blood pressure to rise to potentially dangerous levels.

  AD can be caused by a number of things. The most common causes are a full bladder, bladder infection, severe constipation, or pressure sores. Anything that would normally cause pain or discomfort below the level of the spinal cord injury can trigger dysreflexia. AD can occur during medical tests or procedures and need to be watched for.

  The symptoms that occur with AD are directly related to the types of responses that happen in the sympathetic and parasympathetic nervous systems. Symptoms such as a pounding headache, spots before the eyes, or blurred vision are thee direct result of the high blood pressure that occurs when blood vessels below the injury constrict. The body responds by dilating blood vessels above the injury, causing flushing of the skin, sweating, and occasionally goosebumps. Some patients describe nasal stuffiness and will feel very anxious. Uncontrolled AD can cause a stroke if not treated.

  The treatment for AD involves removing the reason for the stimulation. One of the first things a patient can do is to sit up. This naturally decreases blood pressure. If there is a catheter in place, it should be checked to be certain that there is not a kink in the tubing. If there is not a catheter in place, the patient should be catheterized. The bowels should be checked to be certain there is no stool in the rectum. If the symptoms are caused by skin breakdown, the patient should get to an emergency department as soon as possible.

  The primary risk of AD is stroke. It is a potentially life-threatening condition. If AD is left untreated, the body's attempt to control blood pressure will severely decrease the heart rate. This, combined with uncontrolled high blood pressure, can be fatal. For this reason, it is very important to treat this condition as soon as possible. The most important thing patients can do to prevent AD from occurring is to take good care of themselves. Patients should monitor bladder output (also see bladder care and management) and should maintain a regular bowel program which fully empties the bowels. They should also do regular skin checks to prevent pressure sores from occurring.