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CMAJ • October 28, 2003; 169 (9)
© 2003 Canadian Medical Association or its licensors

Review
Synthèse

Rehabilitation medicine: 1. Autonomic dysreflexia

Jeff Blackmer

From the Division of Rehabilitation Medicine, University of Ottawa, and The Rehabilitation Centre, Ottawa, Ont.

Series editors: Mohan Radhakrishna and Lalith Satkunam

Correspondence to: Dr. Jeff Blackmer, The Rehabilitation Centre, 505 Smyth Rd., Ottawa ON K1H 8M2; fax 613 737-9638; jblackmer{at}ottawahospital.on.ca

Abstract

AUTONOMIC DYSREFLEXIA IS AN ACUTE SYNDROME OF EXCESSIVE, UNCONTROLLED SYMPATHETIC OUTPUT that can occur in patients who have had an injury to the spinal cord (generally at or above the sixth thoracic neurologic level). It is caused by spinal reflex mechanisms that remain intact despite the patient's injury, leading to hypertension. This review describes the clinical features of autonomic dysreflexia, its common causes (most frequently stimulation of the lower urinary tract) and a recommended approach to treatment. The condition can nearly always be managed successfully, but prompt recognition is essential — without treatment there may be dire consequences, including death.


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Rehabilitation medicine: introduction to the series
Mohan Radhakrishna and Lalith Satkunam
Can. Med. Assoc. J. 2003 169: 928. [Full Text] [PDF]



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eLetters:

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Drug therapy for autonomic dysreflexia
Hubert A. Anton
CMAJ, 13 Nov 2003 [Full text]
Anisocoria at autonomic dysreflexia
Aysegul Cakmak
CMAJ, 13 Nov 2003 [Full text]
Reply to Drs. Cakmak and Muslumanoglu
Jeff Blackmer
CMAJ, 28 Nov 2003 [Full text]
Re: Anisocoria at autonomic dysreflexia
Lianne M Hunt
CMAJ, 4 Nov 2004 [Full text]
Metabolic considerations in managing autonomic dysreflexia.
Richard G Fiddian-Green
CMAJ, 26 Nov 2004 [Full text]