Autonomic dysreflexia

Potentially life-threatening condition that can occur in anyone with a spinal cord injury (SCI) at or above mid-thoracic level (T5-7).

Pathophys: autonomic nervous system overrxn
SCI → decreased sympathetic outflow → unopposed parasympathetic signals
Plasticity → overly sensitive to sympathetic triggers below SCI: bladder distention, bowel impaction, pressure ulcers, fractures, and other noxious stimuli below the level of injury

Symptoms
sudden/severe rise in BP
headache
flushing / sweating / chills
blurred vision
nasal congestion
anxiety
bradycardia

Treatment / management:
identify and remove the noxious stimuli
remove of tight-fitting garments
elevate the head of the bed (orthostatically lowers blood pressure)
monitor blood pressure, administer antihypertensive medications