Autonomic Dysreflexia — What is it?

Autonomic dysreflexia is the product of dysregulation of the autonomic system, leading to an uncoordinated response to a noxious stimulus below the level of a spinal cord injury.

Autonomic dysreflexia is a condition that can occur in individuals with spinal cord injuries at or above the level of T6. It is a potentially life-threatening condition that occurs when there is an abnormal response of the autonomic nervous system to a stimulus below the level of injury. The autonomic nervous system is responsible for regulating many of the body’s internal functions, such as blood pressure, heart rate, and sweating.

When the stimulus is below the level of the injury, the autonomic nervous system sends signals to the brain, causing an increase in blood pressure. However, because the signals cannot reach the brain in individuals with spinal cord injuries, the blood pressure continues to rise unchecked.

Common stimuli that can trigger autonomic dysreflexia include:

  • A full bladder or urinary tract infection
  • Constipation or bowel impaction
  • Skin irritation or pressure sores
  • Tight clothing or devices
  • Pain or discomfort below the level of injury

Symptoms of autonomic dysreflexia can include:

  • A sudden increase in blood pressure
  • A pounding headache
  • Flushed or blotchy skin above the level of injury
  • Sweating above the level of injury
  • A slow heart rate
  • Goosebumps below the level of injury
  • Feeling anxious or uneasy

Treatment for autonomic dysreflexia includes:

  • Identifying and removing the triggering stimulus
  • Sitting the individual upright to help lower blood pressure
  • Loosening any tight clothing or devices
  • Seeking medical attention if symptoms do not resolve
  • Administering medications to lower blood pressure if necessary

If left untreated, autonomic dysreflexia can lead to seizures, strokes, and even death.

Treatment for autonomic dysreflexia involves identifying and removing the triggering stimulus, such as emptying the bladder or relieving bowel impaction. If blood pressure remains elevated despite these measures, medications may be necessary to lower it. It is important for individuals with spinal cord injuries and their caregivers to be aware of the symptoms of autonomic dysreflexia and to seek prompt medical attention if they occur.

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