Spinal Cord Injuries

Question 1

What is autonomic dysreflexia?

Answer 1

Occurs in patients who have had a spinal cord injury at, or above the T6 spinal level.

Briefly, afferent signals, most commonly triggered by faecal impaction or urinary retention cause a sympathetic spinal reflex via thoracolumbar outflow.

The usual, centrally mediated, parasympathetic response however is prevented by the cord lesion.

Question 2

What are the 2 most common triggers for autonomic dysreflexia?

Answer 2

1) Faecal impaction

2) Urinary retention

Question 3

Features of autonomic dysreflexia?

Answer 3

An unbalanced physiological reaction:

1) Extreme HTN (key)

2) Flushing & sweating ABOVE the level of the cord lesion

3) Agitation

4) Can result in haemorrhagic stroke (due to extreme HTN)

Question 4

Mx of autonomic dysreflexia?

Answer 4

1) removal/control of the stimulus

2) treatment of any life-threatening hypertension and/or bradycardia