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Living with a Spinal Cord Injury (SCI) has several major side effects, with Autonomic Dysreflexia being one of the most significant (AD). Autonomic dysreflexia is an abnormal reactivity of the involuntary (autonomic) nervous system to stimuli. The good news is that it is typically preventable. When the neurological system of your body is triggered uncomfortably, it can show signs of autonomic dysreflexia.

What is Autonomic Dysreflexia?

Autonomic Dysreflexia is most common in those with a T6 injury or higher. In rare instances, those with lower-level injuries will also develop AD. It is fairly simple to learn the symptoms of Autonomic Dysreflexia, which will serve as your first line of defence.

What Causes Autonomic Dysreflexia?

The most prevalent cause of autonomic dysreflexia (AD) is spinal cord injury. The neural system of people with AD overreacts to stimuli that are not bothersome to healthy people. Some other causes can include:

  • Side effects of some medicines
  • Brain injury and severe head trauma
  • Subarachnoid haemorrhage (a form of brain bleeding)

Autonomic Dysreflexia Signs and Symptoms

Certainly, the symptoms of this condition are so obvious that you will recognise them as soon as it occurs. Once the pain stimuli are removed, the symptoms will quickly fade.

  • Sweating on the Forehead

    Sweating is a severe symptom of Autonomic Dysreflexia. If you notice yourself sweating, particularly on your forehead, check all areas of your body for the possible cause of the pain. You may even find yourself sweating below your injury level and in unusual places, like around your belly button.

  • High Blood Pressure

    Your blood pressure is the most important indicator of Autonomic Dysreflexia since it can mean life or death. A blood pressure of more than 200 mmHg is particularly risky. High blood pressure is triggered by a pain stimulus to the autonomic nervous system, which results in increased blood pressure. If the AD is prolonged, it will rapidly progress into the severe zone, and a stroke may occur.

  • Throbbing Headache

    When Autonomic Dysreflexia is fully activated, a rapid headache will occur if the excruciating stimuli are not removed in time. These headaches will appear “out of nowhere” and can be incredibly painful, usually centred on the frontal lobe of the head; it could feel like a thumping headache.

  • Skin Flushing

    Autonomic Dysreflexia is characterised by skin flushing, particularly a red flushed face. A red flushed face can also be improved rapidly after the pain/stimuli are eliminated, but your skin will also dissipate to normal once your body has stopped feeling the pain causing the Dysreflexia. Sometimes people will have flushed skin below their site of pain, but it is usually limited to the skin above the injured area.

  • Confusion or Anxiety

    Confusion, anxiety, and nervousness are some of the first symptoms of Autonomic Dysreflexia. These states of mind occur during the early stages of Autonomic Dysreflexia and can indicate that something is uncomfortable beneath your level of injury. Always be informed of your mental state and its variations.

Autonomic Dysreflexia Diagnosis

In order to confirm the diagnosis of AD, healthcare providers will typically measure the patient’s blood pressure and heart rate. A systolic blood pressure increase of 20 mmHg or more from baseline, or systolic blood pressure greater than 200 mmHg, is considered indicative of AD. In addition, a decrease in heart rate of 10 beats per minute or more may be observed.

Other tests that may be used to confirm the diagnosis of AD include a neurological exam to assess for spinal cord injury or other underlying neurological conditions, and imaging studies such as magnetic resonance imaging (MRI) or computed tomography (CT) scan to evaluate the spinal cord and other structures.

Common Triggers of Autonomic Dysreflexia

The triggers that can cause autonomic dysreflexia vary from person to person, but some of the most common ones include:

  • Bladder and bowel distention: The most common trigger of autonomic dysreflexia is a distended bladder or rectum. This can be caused by constipation, urinary tract infection, or bladder obstruction.
  • Skin irritation or pressure sores: Skin irritation, pressure sores, or any other kind of skin trauma can trigger autonomic dysreflexia.
  • Temperature changes: Exposure to extreme temperatures, such as cold weather or a hot bath, can cause autonomic dysreflexia.
  • Sexual activity: Sexual activity can cause autonomic dysreflexia, especially in men with SCI.
  • Ingrown toenails or other minor injuries: Even minor injuries, such as ingrown toenails, can trigger autonomic dysreflexia.

Autonomic Dysreflexia Treatment

The treatment for autonomic dysreflexia aims to quickly lower blood pressure and eliminate the underlying cause of the condition. If left untreated, autonomic dysreflexia can lead to serious complications such as seizures, stroke, or even death. Here are some of the treatments that are commonly used for autonomic dysreflexia:

  • Removing the trigger: The first step in treating autonomic dysreflexia is to identify and remove the trigger. This may involve emptying the bladder or bowels, removing tight clothing or shoes, or addressing any other sources of irritation or discomfort.
  • Medications: Medications such as nifedipine or hydralazine can be used to quickly lower blood pressure. These medications work by relaxing the blood vessels, which allows blood to flow more easily and reduces the risk of complications.
  • Intravenous fluids: In some cases, intravenous fluids may be given to help lower blood pressure and maintain hydration.
  • Positioning: Elevating the head of the bed to a sitting position can help reduce blood pressure and alleviate symptoms.
  • Hospitalization: In severe cases, hospitalization may be required to monitor blood pressure and provide more intensive treatment.

It’s important to note that prevention is the best way to manage autonomic dysreflexia. This may involve regular monitoring of bladder and bowel function, maintaining good skin hygiene to prevent pressure ulcers, and avoiding tight clothing or shoes that could trigger an episode. With proper management, most people with autonomic dysreflexia can live normal, healthy lives.

If you are someone dealing with spinal cord injury and looking for alternative treatment options like stem cells for SCI, then get in touch with Advancells at [email protected] or call/WhatsApp us at +91-9654321400.

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