What is Autonomic Dysreflexia?
Autonomic Dysreflexia (AD) is a medical emergency that can affect people with a spinal cord injury at or above the T6 level.
It causes a sudden, dangerous increase in blood pressure (often 20-40 mmHg above normal). AD can happen without warning and may be life-threatening if not treated.
What causes Autonomic Dysreflexia?
AD occurs when something painful irritates the body below the level of injury, but the brain cannot properly control the response. This causes blood pressure to rise quickly.
Common Triggers
- Bladder-related issues are the most common cause, including an overly full bladder (bladder distention), blocked or kinked catheter, or urinary tract infection (UTI).
- Bowel-related issues are the second most common cause, including constipation and fecal impaction.
- Other common triggers:
- Ingrown toenail
- Tight clothing
- Pressure sores
- Prolonged pressure from objects (e.g., abdominal binder, brace, or tight shoes)
- Sexual intercourse
- Menstruation
Signs and Symptoms
AD symptoms may appear suddenly and can include:
- Sudden increase in blood pressure
- Decreased (slowed) heart rate
- Severe or pounding headache
- Blurred vision
- Anxiety or feeling unwell
- Flushing or sweating above the level of injury
- Goosebumps
How to Respond
Treat these symptoms as an emergency!
- Sit upright immediately
- Find and remove the cause
- Monitor blood pressure
- Call emergency services if symptoms do not improve or cause cannot be found
Ways to Prevent Autonomic Dysreflexia
- Empty bladder regularly
- Check catheters often
- Follow bowel program
- Avoid excessively tight clothing
- Inspect skin daily
Autonomic dysreflexia is a serious but manageable condition. Recognizing the signs and acting quickly can help prevent serious injury. When in doubt, seek emergency medical care.