User:Mr. Ibrahem/Autonomic dysreflexia

Autonomic dysreflexia (AD) is a condition that may occur after a spinal cord injury. Symptoms include episodes of high blood pressure which may result in headaches. During these episoids sweating above the level of injury, stuffy nose, low heart rate, and anxiety may also occur. Onset is often a month to a year after injury. Multiple episodes may occur a day. Complications may include stroke, intracranial bleed, pulmonary edema, and seizures.

It most commonly occurs with lesions above the T6 spinal cord level, although there are reports with as low as T10. The risk is greater the higher the level of injury. Common triggers for attacks include urinary tract infections, urinary retention, constipation, and hemorrhoids. The underlying mechanism involves over activity of the sympathetic nervous system with a lack of compensatory parasympathetic response. Diagnosis may be based on symptoms together with blood pressure measurement.

It is a medical emergency. Initial treatment involves sitting the person upright, removing any constrictive clothing, and addressing whatever triggered the episode. This may require a urinary catheter or digital disimpaction of the bowels. If blood pressure remains above 150 mmHg, medications such as nitroglycerin, prazosin, nifedipine, or hydralazine may be used. Other measures may include injecting botox into the bladder. Prevention involves education regarding potential precipitating events.

Autonomic dysreflexia occurs in 20 to 70% of people with a spinal cord injury above T6. It is associated with a 22% risk of death. The condition was first described in 1860 by Hilton. Many people with the condition carry medications to treat the condition out in the community.