Learn About Autonomic Dysreflexia

What is the definition of Autonomic Dysreflexia?

Autonomic dysreflexia 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)
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What are the alternative names for Autonomic Dysreflexia?

Autonomic hyperreflexia; Spinal cord injury - autonomic dysreflexia; SCI - autonomic dysreflexia

What are the causes of Autonomic Dysreflexia?

The most common cause of autonomic dysreflexia (AD) is spinal cord injury. The nervous system of people with AD over-responds to the types of stimulation that do not bother healthy people.

Other causes include:

  • 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
What are the symptoms of Autonomic Dysreflexia?

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.

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What are the current treatments for Autonomic Dysreflexia?

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 the head
  • Remove tight clothing

Proper treatment depends on the cause. If medicines or illegal drugs are causing the symptoms, those drugs must be stopped. Any illness needs to be treated. For example, the provider will check for a blocked urinary catheter and signs of constipation.

If a slowing of the heart rate is causing AD, drugs 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.

Who are the top Autonomic Dysreflexia Local Doctors?
Highly rated in

Spaulding Rehabilitation Network

Spaulding Rehabilitation Hospital Boston

300 1st Ave 
Boston, MA 2129

Ryan Solinsky is a Physiatrist in Boston, Massachusetts. Dr. Solinsky has been practicing medicine for over 10 years and is rated as an Elite doctor by MediFind in the treatment of Autonomic Dysreflexia. He is also highly rated in 2 other conditions, according to our data. His top areas of expertise are Autonomic Dysreflexia, Paraplegia, Transverse Myelitis, and Spasticity. He is licensed to treat patients in Washington. Dr. Solinsky is currently accepting new patients.

Highly rated in

Leeds Teaching Hospitals NHS Trust

Leeds, ENG, GB 

Subramanian Vaidyanathan is in Leeds, United Kingdom. Vaidyanathan is rated as an Elite expert by MediFind in the treatment of Autonomic Dysreflexia. They are also highly rated in 9 other conditions, according to our data. Their top areas of expertise are Bilateral Hydronephrosis, Autonomic Dysreflexia, Bladder Stones, and Hydronephrosis.

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Highly rated in

University Of British Columbia

Md/phd Training Program, Faculty Of Medicine 
Vancouver, BC, CA 

Jordan Squair is in Vancouver, Canada. Squair is rated as an Elite expert by MediFind in the treatment of Autonomic Dysreflexia. He is also highly rated in 3 other conditions, according to our data. His top areas of expertise are Autonomic Dysreflexia, Low Blood Pressure, Orthostatic Hypotension, and Urinary Tract Infection.

What is the outlook (prognosis) for Autonomic Dysreflexia?

Outlook depends on the cause.

People with AD due to a medicine usually recover when that medicine is stopped. When AD is caused by other factors, recovery depends on how well the disease can be treated.

What are the possible complications of Autonomic Dysreflexia?

Complications may occur due to side effects of medicines used to treat the condition. Long-term, severe high blood pressure may cause seizures, bleeding in the eyes, stroke, or death.

When should I contact a medical professional for Autonomic Dysreflexia?

Call your provider right away if you have symptoms of AD.

How do I prevent Autonomic Dysreflexia?

To prevent AD, do not take medicines that cause this condition or make it worse.

In people with spinal cord injury, the following may also help prevent AD:

  • 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
Central nervous system and peripheral nervous system
What are the latest Autonomic Dysreflexia Clinical Trials?
Acute Effects of Continuous Verses Interval Aerobic Training on Autonomic Dysreflexia in Spinal Cord Injury Patient
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The Evaluation of Antimicrobial Bladder Instillation on the Prevalence of Chronic Urinary Tract Infections and Bladder Dysfunction in Persons With Spinal Cord Injury
What are the Latest Advances for Autonomic Dysreflexia?
Diagnostic and Therapeutic Particularities in Abdominal Trauma Associated with Spinal Cord Injuries - Review of the Literature.
Autonomic dysreflexia in spinal cord injury patients: recognition is vital.
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Noninvasive spinal stimulation safely enables upright posture in children with spinal cord injury.
Who are the sources who wrote this article ?

Published Date : June 23, 2020
Published By : Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Cheshire WP. Autonomic disorders and their management. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 390.

Cowan H. Autonomic dysreflexia in spinal cord injury. Nurs Times. 2015;111(44):22-24. PMID: 26665385 pubmed.ncbi.nlm.nih.gov/26665385/.

McDonagh DL, Barden CB. Autonomic dysreflexia. In: Fleisher LA, Rosenbaum SH, eds. Complications in Anesthesia. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 131.