Autonomic Dysreflexia Overview
Learn About Autonomic Dysreflexia
Autonomic dysreflexia (AD) is an abnormal, overreaction of the involuntary (autonomic) nervous system to stimulation. This reaction may include:
- Change in heart rate
- Excessive sweating
- High blood pressure
- Muscle spasms
- Skin color changes (paleness, redness, blue-gray skin color)
Autonomic hyperreflexia; Spinal cord injury - autonomic dysreflexia; SCI - autonomic dysreflexia; Sympathetic hyperreflexia
The cause of AD is spinal cord injury, most often due to spine trauma. The nervous system of people with AD over-responds to the types of stimulation that do not bother healthy people.
Other conditions may cause autonomic dysfunction (not dysreflexia) which has similar symptoms, including:
- Guillain-Barré syndrome (disorder in which the body's immune system mistakenly attacks part of the nervous system)
- Side effects of some medicines
- Severe head trauma and other brain injuries
- Subarachnoid hemorrhage (a form of brain bleeding)
- Use of illegal stimulant drugs such as cocaine and amphetamines
Symptoms can include any of the following:
- Anxiety or worry
- Bladder or bowel problems
- Blurry vision, widened (dilated) pupils
- Lightheadedness, dizziness, or fainting
- Fever
- Goosebumps, flushed (red) skin above the level of the spinal cord injury
- Heavy sweating
- High blood pressure
- Irregular heartbeat, slow or fast pulse
- Muscle spasms, especially in the jaw
- Nasal congestion
- Throbbing headache
Sometimes there are no symptoms, even with a dangerous rise in blood pressure.
AD is life threatening, so it is important to quickly find and treat the problem.
A person with symptoms of AD should:
- Sit up and raise their head
- Remove tight clothing
Proper treatment depends on the cause. If medicines or illegal drugs are worsening the symptoms, they must be stopped. Any illness needs to be treated. For example, the provider will check for a blocked urinary catheter and signs of constipation which may cause AD in someone with a spinal cord injury. The person should be checked for injuries, sores, or other irritants that may be triggering the symptoms.
If a slowing of the heart rate is causing AD, medicines called anticholinergics (such as atropine) may be used.
Very high blood pressure needs to be treated quickly but carefully, because the blood pressure can drop suddenly.
A pacemaker may be needed for an unstable heart rhythm.
Andrei Krassioukov practices in Vancouver, Canada. Mr. Krassioukov is rated as an Elite expert by MediFind in the treatment of Autonomic Dysreflexia. His top areas of expertise are Autonomic Dysreflexia, Low Blood Pressure, Familial Dysautonomia, and Orthostatic Hypotension.
Jordan Squair practices in Vancouver, Canada. Mr. Squair is rated as an Elite expert by MediFind in the treatment of Autonomic Dysreflexia. His top areas of expertise are Autonomic Dysreflexia, Orthostatic Hypotension, Low Blood Pressure, Familial Dysautonomia, and Deep Brain Stimulation.
Matthias Walter practices in Basel, Switzerland. Mr. Walter is rated as an Elite expert by MediFind in the treatment of Autonomic Dysreflexia. His top areas of expertise are Autonomic Dysreflexia, Neurogenic Bladder, Asymptomatic Bacteriuria, Neurogenic Bowel, and Penectomy.
Outlook depends on the cause.
People with autonomic dysfunction due to a medicine usually recover when that medicine is stopped. When AD is aggravated by other factors, recovery depends on how well the disease can be treated.
Complications may occur due to side effects of medicines used to treat the condition. A sudden severe increase in blood pressure can cause a stroke or bleeding into the brain. Long-term, severe high blood pressure may cause seizures, bleeding in the eyes, stroke, or death.
Contact your provider right away if you have symptoms of AD.
In people with spinal cord injury, the following may help lessen AD symptoms:
- Avoid medicines that make AD symptoms worse
- Do not let the bladder become too full
- Pain should be controlled
- Practice proper bowel care to avoid stool impaction
- Practice proper skin care to avoid bedsores and skin infections
- Prevent bladder infections
Summary: This study looks to characterize gradients of dysfunction in the autonomic nervous system after spinal cord injury. The autonomic nervous system plays key roles in regulation of blood pressure, skin blood flow, and bladder health- all issues that individuals with spinal cord injury typically suffer. Focusing on blood pressure regulation, the most precise metric with broad clinical applicability, t...
Summary: This study looks to characterize gradients of dysfunction in the autonomic nervous system in patients with clinically diagnosed multiple sclerosis. The autonomic nervous system plays key roles in regulation of blood pressure, skin blood flow, and bladder health- all issues that individuals with multiple sclerosis typically suffer. Focusing on blood pressure regulation, the most precise metric with...
Published Date: June 13, 2024
Published By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Benarroch EE, Freeman R. Autonomic disorders. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 386.
Khanna R, Fessler RD, Snyder L, Fessler RG. Spinal cord trauma. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 63.
McDonagh DL, Barden CB. Autonomic dysreflexia. In: Fleisher LA, Rosenbaum SH, eds. Complications in Anesthesia. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 131.