Dysreflexia Autonomic Hyperreflexia

Autonomic hyperreflexia is an abnormal triggering of the autonomicnervous system. It occurs after a spinal cord injury.The body is unable to turn off the nerves that cause blood pressure to rise.

What is going on in the body?

Normally, the autonomic nervous system controlsblood pressureautomatically. It does this by commanding muscles around blood vessels totighten or relax in order to raise or lower blood pressure. The nervous system canmonitor blood pressure and continually adjusts the commands to keep blood pressurenormal.

When a person has a spinal cord injury,it can cause damage to nerves in the spinal cord. And this results in a loss of controlin the nerves. This can happenif the damage to the spinal cord is in the neck or upper back. The bones of the spineare each labeled and numbered. Damage at the 6th thoracic bone or higher meansthe person may develop this problem. If the damage is lower, autonomic hyperreflexiawill not be a problem.

In autonomic hyperreflexia, the autonomic nervous system can stillcause the blood pressure to rise. But it cannot easily cause it to come back down.

What are the causes and risks of the disease?

Below the level of damage in the spinal cord, the person usually isparalyzed and cannot feel normal sensations. Autonomic hyperreflexia occurswhen an irritating stimulus occurs that the person cannot feel. The most commoncause is a very full bladder. The bladder sends signals through the nervous systemto the brain. The signals cannot get through because of the spinal cord damage.The person cannot feel that the bladder is full and needs to be emptied. But theautomatic part of the nervous system that controls the blood pressure still getstriggered and causes the blood pressure to go up.

Other common causes are a full bowel, an infection, or a sore on theskin. Women with spinal cord injuries who have menstrual cramps may also have autonomic hyperreflexia.Sometimes the trigger is as simple as accidentally sitting on a hard object orhaving clothing bunched up.

What are the signs and symptoms of the disease?

Autonomic hyperreflexia can cause the person’s blood pressure to riseto a danger level. Symptoms may include:

The severity of the symptoms can depend on how high the bloodpressure goes. The symptoms go away quickly once the blood pressure drops tohealthy levels.

How is the disease diagnosed?

Usually the person begins to feel the symptoms and quicklyrecognizes the autonomic hyperreflexia. Checking the blood pressurecan confirm the hyperreflexia. It is important to begin right away to look for thecause and fix it.

What can be done to prevent the disease?

A person with a spinal cord injuryneeds to learn the symptoms and causes of autonomic hyperreflexia. Keeping thebladder and bowel empty, taking good care of the skin, and avoiding infections arealso key actions that can help.

What are the long-term effects of the disease?

Once the cause of the autonomic hyperreflexia is removed, thecondition goes away quickly. There are no long-term effects if the hyperreflexiais treated promptly. If treatment is not quick enough or is inadequate, the personmay have a stroke.The stroke may cause speech impairments,cognitive impairments,and inability to move about as easily as others\ \limited movement of arms or legs\ \decrease in strength or control of the muscles and bones\ \abnormal or impaired coordination\ \medical condition requiring bed rest\ mobility impairments.

What are the risks to others?

There are no risks to others.

What are the treatments for the disease?

Autonomic hyperreflexia is a medical emergency. If the blood pressurestays high or continues to go up, a strokecan occur. The good news is that it is easy to treat.

The best treatment is to remove whatever is causing the autonomichyperreflexia. This means emptying the bladder or bowels and making sure theperson is not sitting on bunched-up clothing or a hard object. If the person is lyingdown, sitting up can help lower the blood pressure. Once the cause is removed, thesymptoms improve quickly.

If the cause cannot be found or the problem persists, the person or their caregiver will need tocontact emergency medical servicesright away. Medicines can be used to bring the blood pressure down to normal.

What are the side effects of the treatments?

Side effects vary depending on the medicines used to lower the bloodpressure but may include allergic reactions.

What happens after treatment for the disease?

Autonomic hyperreflexia goes away quickly once the cause is removed.Remember that the problem can return, so care must always betaken to prevent another episode.

How is the disease monitored?

Usually, the person will notice symptoms as they occur. So they can make surethe problem is quickly taken care of. It’s a good idea to notify the doctorwhen an episode occurs unexpectedly. Any new or worsening symptoms should bereported to the doctor as well.