Clinical Features of Autonomic Dysreflexia in Patients with Spinal Cord Injury

Jung, Kwan Gyu; Park, Won Hee; Shim, Hong Bang

Abstract

Autonomic dysreflexia is a syndrome characterized by severe hypertension, headache, sweating that is seen in spinal cord injury population. It can be a life-threatening problem if not promptly recognized and treated. Since the most common cause is bladder distention, it is essential that the urologist sh6fild be familiar with this syndrome. Two hundred ninety four patients with spinal cord injury were reviewed for the prevalence rate and clinical manifestations of autonomic dysreflexia. The time of onset post-injury, precipitating causes, presenting symptoms and management were analyzed. 42 patients (34.4%) of 122 patients with lesion above T6 level exhibited autonomic dysreflexia. The majority of patients (61.9%) had manifested signs and symptoms of autonomic dysreflexia within the first year. The precipitating causes were bladder distention (69.0%), bowel distention (23.8%) and urinary tract infection (7.1%). The presenting symptoms of autonomic dysreflexia were headache (88.1%), sweating (88.1%), hot flushing (28.6%), chest discomfort, hyperpnea and spasm. The management of autonomic dysreflexia include prompt bladder erupting, bed rest and appropriate bowel preparation. In conclusion, prompt recognition and appropriate management of autonomic dysreflexia are essential to prevent life-threatening sequelae.