Autonomic Dysreflexia

Autonomic dysreflexia can be caused by any painful stimulus which occurs below the level of injury.

As the spinal cord is damaged, signals cannot pass normally to the brain to let it know that there is a problem. The autonomic nervous system then sets off a series of symptoms which raise the alarm that there is an issue.

Normally the autonomic nervous system maintains our body homeostasis or balance at an unconscious level. This involuntary part of the nervous system controls the functions of the body which occur automatically (heart rate, blood pressure, appetite, temperature control etc.) In spinal injuries T6 or above, this balance is interrupted. The body produces exaggerated, abnormal nerve signals which cause problems above and below the level of injury.

The signs and symptoms can be mild or severe:

• Pounding headache
• Flushing blotchy skin
• Slow heart rate
• Sweating above injury level
• Goosebumps
• Tingling sensation on face or neck
• Stuffy nose
• Anxiety
• High blood pressure

If you have experienced autonomic dysreflexia, you will be familiar with the signs and symptoms which affect you and will be able to alert someone quickly.

Bladder

• Overfull bladder
• Bladder/kidney stones
• Urinary tract infection
• Blocked catheter

For more information, see the section on managing your bladder.

Bowels

• Constipation
• Distension
• Haemorrhoids

For more information, see the section on managing your bowels.

Other

• Prolonged pressure
• Pressure sore
• Ingrown toenail
• Deep vein thrombosis
• Fracture

It is important to find and relieve the cause of dysreflexia. Try to identify the cause from the most common triggers listed above. Locating, treating or removing the cause will allow your symptoms to settle.

Firstly, raise your head by sitting up in bed to a maximum of 45 degrees. This allows blood to pool to your lower limbs and your blood pressure will fall.

If symptoms persist, your doctor may prescribe medication such as bite and swallow nifedipine 10mg. If symptoms remain despite taking nifedipine, contact your doctor.

It is important to have nifedipine to hand even when out of hospital.

We advise you to carry a medical alert card for the emergency treatment of autonomic dysreflexia. This will be given to you before you are discharged