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Autonomic dysreflexia

MedGen UID:
66758
•Concept ID:
C0238015
•
Disease or Syndrome
Synonyms: Autonomic Dysreflexia; Autonomic Dysreflexia, Spinal; Autonomic Dysreflexias; Autonomic Dysreflexias, Spinal; Autonomic Hyperreflexia; Autonomic Hyperreflexias; Dysreflexia, Autonomic; Dysreflexia, Spinal Autonomic; Dysreflexias, Autonomic; Dysreflexias, Spinal Autonomic; Hyperreflexia, Autonomic; Hyperreflexias, Autonomic; Spinal Autonomic Dysreflexia; Spinal Autonomic Dysreflexias
SNOMED CT: Dysreflexia (129618003); Autonomic dysreflexia (129618003)
 
Monarch Initiative: MONDO:0043975

Definition

A syndrome associated with damage to the spinal cord above the mid thoracic level (see SPINAL CORD INJURIES) characterized by a marked increase in the sympathetic response to minor stimuli such as bladder or rectal distention. Manifestations include HYPERTENSION; TACHYCARDIA (or reflex bradycardia); FEVER; FLUSHING; and HYPERHIDROSIS. Extreme hypertension may be associated with a STROKE. (From Adams et al., Principles of Neurology, 6th ed, pp538 and 1232; J Spinal Cord Med 1997;20(3):355-60) [from MONDO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVAutonomic dysreflexia

Professional guidelines

PubMed

Autonomic dysreflexia: Current pharmacologic management.
Solinsky R
PM R 2023 Dec;15(12):1519-1523. Epub 2023 Sep 13 doi: 10.1002/pmrj.13051. PMID: 37545115Free PMC Article
Exercise and sports science Australia (ESSA) position statement on exercise and spinal cord injury.
Tweedy SM, Beckman EM, Geraghty TJ, Theisen D, Perret C, Harvey LA, Vanlandewijck YC
J Sci Med Sport 2017 Feb;20(2):108-115. Epub 2016 Mar 9 doi: 10.1016/j.jsams.2016.02.001. PMID: 27185457
Passive movements for the treatment and prevention of contractures.
Prabhu RK, Swaminathan N, Harvey LA
Cochrane Database Syst Rev 2013 Dec 28;2013(12):CD009331. doi: 10.1002/14651858.CD009331.pub2. PMID: 24374605Free PMC Article

Recent clinical studies

Etiology

Autonomic Hyperactivity.
Rabinstein AA
Continuum (Minneap Minn) 2020 Feb;26(1):138-153. doi: 10.1212/CON.0000000000000811. PMID: 31996626
Exercise and sports science Australia (ESSA) position statement on exercise and spinal cord injury.
Tweedy SM, Beckman EM, Geraghty TJ, Theisen D, Perret C, Harvey LA, Vanlandewijck YC
J Sci Med Sport 2017 Feb;20(2):108-115. Epub 2016 Mar 9 doi: 10.1016/j.jsams.2016.02.001. PMID: 27185457
Perioperative hypertensive emergencies.
Aronson S
Curr Hypertens Rep 2014 Jul;16(7):448. doi: 10.1007/s11906-014-0448-6. PMID: 24852830
Autonomic dysreflexia and telehealth.
Lapierre NM, Blackmer J, Coutu-Wakulczyk G, Dehoux E
Can Nurse 2006 Sep;102(7):20-5. PMID: 16989096
Exercise recommendations for individuals with spinal cord injury.
Jacobs PL, Nash MS
Sports Med 2004;34(11):727-51. doi: 10.2165/00007256-200434110-00003. PMID: 15456347

Diagnosis

Autonomic dysreflexia in spinal cord injury.
Cowan H, Lakra C, Desai M
BMJ 2020 Oct 2;371:m3596. doi: 10.1136/bmj.m3596. PMID: 33008797
Autonomic Hyperactivity.
Rabinstein AA
Continuum (Minneap Minn) 2020 Feb;26(1):138-153. doi: 10.1212/CON.0000000000000811. PMID: 31996626
Autonomic Disorders.
Novak P
Am J Med 2019 Apr;132(4):420-436. Epub 2018 Oct 9 doi: 10.1016/j.amjmed.2018.09.027. PMID: 30308186
Exercise recommendations for individuals with spinal cord injury.
Jacobs PL, Nash MS
Sports Med 2004;34(11):727-51. doi: 10.2165/00007256-200434110-00003. PMID: 15456347
Autonomic dysreflexia.
Earl GP
MCN Am J Matern Child Nurs 2002 Mar-Apr;27(2):93-7. doi: 10.1097/00005721-200203000-00008. PMID: 11984277

Therapy

Symptomatic Treatment of Myelopathy.
Chuang K
Continuum (Minneap Minn) 2024 Feb 1;30(1):224-242. doi: 10.1212/CON.0000000000001383. PMID: 38330480
Autonomic dysreflexia: Current pharmacologic management.
Solinsky R
PM R 2023 Dec;15(12):1519-1523. Epub 2023 Sep 13 doi: 10.1002/pmrj.13051. PMID: 37545115Free PMC Article
Peripherally delivered Adeno-associated viral vectors for spinal cord injury repair.
Sydney-Smith JD, Spejo AB, Warren PM, Moon LDF
Exp Neurol 2022 Feb;348:113945. Epub 2021 Dec 8 doi: 10.1016/j.expneurol.2021.113945. PMID: 34896114
Iatrogenic urological triggers of autonomic dysreflexia: a systematic review.
Liu N, Zhou M, Biering-Sørensen F, Krassioukov AV
Spinal Cord 2015 Jul;53(7):500-9. Epub 2015 Mar 24 doi: 10.1038/sc.2015.39. PMID: 25800696
Perioperative hypertensive emergencies.
Aronson S
Curr Hypertens Rep 2014 Jul;16(7):448. doi: 10.1007/s11906-014-0448-6. PMID: 24852830

Prognosis

Women's Sexual Health and Reproductive Function After SCI.
Courtois F, Alexander M, McLain ABJ
Top Spinal Cord Inj Rehabil 2017 Winter;23(1):20-30. doi: 10.1310/sci2301-20. PMID: 29339874Free PMC Article
Cardiac electrophysiology of patients with spinal cord injury.
Manogue M, Hirsh DS, Lloyd M
Heart Rhythm 2017 Jun;14(6):920-927. Epub 2017 Feb 12 doi: 10.1016/j.hrthm.2017.02.015. PMID: 28215570
Sympathetic skin responses and autonomic dysfunction in spinal cord injury.
Berger MJ, Hubli M, Krassioukov AV
J Neurotrauma 2014 Sep 15;31(18):1531-9. Epub 2014 Aug 27 doi: 10.1089/neu.2014.3373. PMID: 24874269
Exercise recommendations for individuals with spinal cord injury.
Jacobs PL, Nash MS
Sports Med 2004;34(11):727-51. doi: 10.2165/00007256-200434110-00003. PMID: 15456347
Neurogenic bladder dysfunction.
Madersbacher HG
Curr Opin Urol 1999 Jul;9(4):303-7. doi: 10.1097/00042307-199907000-00005. PMID: 10459465

Clinical prediction guides

Nurses and physiotherapists' knowledge levels on autonomic dysreflexia in a rehabilitation hospital.
Kaydok E
J Spinal Cord Med 2023 Jul;46(4):569-573. Epub 2021 Dec 2 doi: 10.1080/10790268.2021.1983313. PMID: 34855570Free PMC Article
What do physiotherapists and physiotherapy students know about autonomic dysreflexia?
Tederko P, Ugniewski K, Bobecka-Wesołowska K, Tarnacka B
J Spinal Cord Med 2021 May;44(3):418-424. Epub 2019 Aug 12 doi: 10.1080/10790268.2019.1645966. PMID: 31403393Free PMC Article
Autonomic Hyperactivity.
Rabinstein AA
Continuum (Minneap Minn) 2020 Feb;26(1):138-153. doi: 10.1212/CON.0000000000000811. PMID: 31996626
Cardiac electrophysiology of patients with spinal cord injury.
Manogue M, Hirsh DS, Lloyd M
Heart Rhythm 2017 Jun;14(6):920-927. Epub 2017 Feb 12 doi: 10.1016/j.hrthm.2017.02.015. PMID: 28215570
Bradycardia in neurosurgery.
Agrawal A, Timothy J, Cincu R, Agarwal T, Waghmare LB
Clin Neurol Neurosurg 2008 Apr;110(4):321-7. Epub 2008 Mar 7 doi: 10.1016/j.clineuro.2008.01.013. PMID: 18329164

Recent systematic reviews

Cold pressor test in spinal cord injury-revisited.
Hubli M, Bolt D, Krassioukov AV
Spinal Cord 2018 Jun;56(6):528-537. Epub 2017 Dec 20 doi: 10.1038/s41393-017-0037-z. PMID: 29259348
Iatrogenic urological triggers of autonomic dysreflexia: a systematic review.
Liu N, Zhou M, Biering-Sørensen F, Krassioukov AV
Spinal Cord 2015 Jul;53(7):500-9. Epub 2015 Mar 24 doi: 10.1038/sc.2015.39. PMID: 25800696
Sexual function and autonomic dysreflexia in men with spinal cord injuries: how should we treat?
Courtois F, Rodrigue X, Côté I, Boulet M, Vézina JG, Charvier K, Dahan V
Spinal Cord 2012 Dec;50(12):869-77. Epub 2012 Aug 7 doi: 10.1038/sc.2012.83. PMID: 22869221
Autonomic dysreflexia: an important cardiovascular complication in spinal cord injury patients.
Gunduz H, Binak DF
Cardiol J 2012;19(2):215-9. doi: 10.5603/cj.2012.0040. PMID: 22461061
A systematic review of the management of autonomic dysreflexia after spinal cord injury.
Krassioukov A, Warburton DE, Teasell R, Eng JJ; Spinal Cord Injury Rehabilitation Evidence Research Team
Arch Phys Med Rehabil 2009 Apr;90(4):682-95. doi: 10.1016/j.apmr.2008.10.017. PMID: 19345787Free PMC Article

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