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Acute Autonomic Dysreflexia

Sudden severe hypertensive crisis in patients with spinal cord injury above T6.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Acute Autonomic Dysreflexia?

Autonomic dysreflexia is a syndrome of uncontrolled sympathetic discharge below the level of injury in spinal cord injuries above T6.

The most common triggers are bladder distension (catheter blockage), bowel impaction, pressure ulcer, urinary tract infection and ingrown nail.

Without intervention, severe hypertension may cause cerebral haemorrhage, seizure and death; rapid removal of trigger and antihypertensive treatment are life-saving.

Symptoms

Sudden severe headache (throbbing)
Hypertension (>20 mmHg above baseline systolic)
Bradycardia or tachycardia
Sweating, flushing and goosebumps above injury level
Pale, dry skin below injury level
Nasal congestion and visual blurring
Anxiety, nausea and confusion

Risk Factors

Spinal cord injury above T6 level
Bladder distension (catheter blockage, urinary retention)
Bowel impaction and constipation
Pressure ulcer (decubitus)
Urinary tract infection
Ingrown nail and lower extremity infection
Pregnancy, labour and surgical procedures

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Emergency presentation by 112 ambulance is mandatory for severe headache, sweating and signs of hypertensive crisis
  • Trigger investigation and removal must be performed within minutes
  • Frequent recurrence requires bladder-bowel programme review
  • Patients should carry an emergency information card on their person

Treatment Methods

01
Sit upright and lower legs (orthostatic effect)
02
Loosen tight clothing and remove constricting items
03
Bladder evacuation (catheter check, irrigation)
04
Bowel evacuation (digital extraction, manual)
05
Sublingual nifedipine or topical nitroglycerin (10 mg)
06
Skin and pressure-ulcer evaluation

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Acil Servis Department

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.