Dysreflexia SCI, more accurately referred to as autonomic dysreflexia (AD) in the context of spinal cord injury (SCI), is a dangerous condition that can occur after a spinal cord injury. It's particularly common when the injury is at or above the T6 level.
Understanding Autonomic Dysreflexia
Autonomic dysreflexia is characterized by a sudden onset of excessively high blood pressure. It's triggered by a noxious stimulus below the level of the spinal cord injury. Because of the spinal cord injury, the signals from the brain that would normally regulate the body's response to these stimuli are blocked. This leads to an uncoordinated and exaggerated response of the autonomic nervous system.
Who is at Risk?
- Individuals with spinal cord injuries at or above the T6 level are most at risk.
- The higher the level of the injury in the spinal cord, the greater the risk. Up to 90% of individuals with cervical or high-thoracic spinal cord injuries may be susceptible.
Common Triggers
Many different stimuli can trigger autonomic dysreflexia, including:
- Bladder Issues:
- A full bladder is the most common trigger.
- Urinary tract infections (UTIs).
- Blocked or kinked catheters.
- Bowel Issues:
- Constipation or impaction.
- Hemorrhoids.
- Skin Problems:
- Pressure sores.
- Ingrown toenails.
- Burns.
- Other Stimuli:
- Tight or restrictive clothing.
- Pain.
- Sexual activity.
- Even minor procedures.
Symptoms
Symptoms can vary, but some common signs include:
- Severe headache
- Sudden increase in blood pressure (often dangerously high)
- Profuse sweating above the level of the injury
- Flushing of the skin above the level of the injury
- Slow heart rate (bradycardia)
- Goosebumps below the level of the injury
- Blurred vision or spots in the field of vision
- Nasal congestion
- Anxiety
Why is it Dangerous?
Autonomic dysreflexia is a medical emergency. If left untreated, it can lead to:
- Stroke
- Seizure
- Myocardial infarction (heart attack)
- Death
What to Do
If you suspect someone is experiencing autonomic dysreflexia:
- Sit the person up to help lower blood pressure.
- Loosen anything tight (clothing, shoes, etc.).
- Check the bladder: If a catheter is in place, check for kinks or blockages. If not, check for bladder distension.
- Check the bowel: Look for signs of constipation or impaction.
- Monitor blood pressure every few minutes.
- Seek immediate medical attention.
