BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuAutonomic dysreflexiaAutonomic hyperreflexia; Spinal cord injury - autonomic dysreflexia; SCI - autonomic dysreflexiaAutonomic dysreflexia is an abnormal, overreaction of the involuntary (autonomic) nervous system to stimulation. This reaction may include: Change in heart rate Excessive sweating High blood pressure Muscle spasms Skin color changes (paleness, redness, blue-gray skin color) Causes The most common cause of autonomic dysreflexia (AD) is spinal cord injury. The nervous system of people with AD over-responds to the types of stimulation that do not bother healthy people.Other causes include: Guillain-Barré syndrome (disorder in which the body's immune system mistakenly attacks part of the nervous system) Guillain-Barré syndromeGuillain-Barré syndrome (GBS) is a serious health problem that occurs when the body's defense (immune) system mistakenly attacks part of the peripher...ImageRead Article Now Book Mark Article Side effects of some medicines Severe head trauma and other brain injuries Subarachnoid hemorrhage (a form of brain bleeding) Subarachnoid hemorrhageSubarachnoid hemorrhage is bleeding in the area between the brain and the thin tissues that cover the brain. This area is called the subarachnoid sp...Read Article Now Book Mark Article Use of illegal stimulant drugs such as cocaine and amphetamines Symptoms Symptoms can include any of the following:Anxiety or worry Bladder or bowel problems Blurry vision, widened (dilated) pupils Lightheadedness, dizziness, or fainting Fever Goosebumps, flushed (red) skin above the level of the spinal cord injury Heavy sweating High blood pressure Irregular heartbeat, slow or fast pulse Muscle spasms, especially in the jaw Nasal congestion Throbbing headacheSometimes there are no symptoms, even with a dangerous rise in blood pressure. Exams and Tests The health care provider will do a complete nervous system and medical examination. Tell the provider about all the medicines you are taking now and that you took in the past. This helps determine which tests you need.Tests may include:Blood and urine tests CT or MRI scan CTA computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...ImageRead Article Now Book Mark Article MRI scanA magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...ImageRead Article Now Book Mark Article ECG (measurement of the heart's electrical activity) ECGAn electrocardiogram (ECG) is a test that records the electrical activity of the heart.ImageRead Article Now Book Mark Article Lumbar puncture Lumbar punctureCerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...ImageRead Article Now Book Mark Article Tilt-table testing (testing of blood pressure as the body position changes) Toxicology screening (tests for any drugs, including medicines, in your bloodstream) X-rays Other conditions share many symptoms with AD, but have a different cause. The exam and testing help the provider rule out these other conditions, including:Carcinoid syndrome (tumors of the small intestine, colon, appendix, and bronchial tubes in the lungs) Carcinoid syndromeCarcinoid syndrome is a group of symptoms associated with carcinoid tumors. These are tumors most often of the small intestine, colon, appendix, or ...ImageRead Article Now Book Mark Article Neuroleptic malignant syndrome (a condition caused by some medicines that leads to muscle stiffness, high fever, and drowsiness) Pheochromocytoma (tumor of the adrenal gland) PheochromocytomaPheochromocytoma is a rare tumor of adrenal gland tissue. It results in the release of too much epinephrine and norepinephrine, hormones that contro...ImageRead Article Now Book Mark Article Serotonin syndrome (drug reaction that causes the body to have too much serotonin, a chemical produced by nerve cells) Serotonin syndromeSerotonin syndrome (SS) is a potentially life-threatening drug reaction. It causes the body to have too much serotonin, a chemical produced by some ...Read Article Now Book Mark Article Thyroid storm (life-threatening condition from an overactive thyroid) Thyroid stormThyroid storm is a rare life-threatening condition of the thyroid gland. It develops in cases of untreated hyperthyroidism, or overactive thyroid (t...ImageRead Article Now Book Mark Article Treatment AD is life threatening, so it is important to quickly find and treat the problem.A person with symptoms of AD should:Sit up and raise the head Remove tight clothingProper treatment depends on the cause. If medicines or illegal drugs are causing the symptoms, those drugs must be stopped. Any illness needs to be treated. For example, the provider will check for a blocked urinary catheter and signs of constipation which may cause AD in someone with a spinal cord injury.If a slowing of the heart rate is causing AD, drugs called anticholinergics (such as atropine) may be used.Very high blood pressure needs to be treated quickly but carefully, because the blood pressure can drop suddenly.A pacemaker may be needed for an unstable heart rhythm.PacemakerA pacemaker is a small, battery-operated device. This device senses when your heart is beating too slowly. It sends a signal to your heart that mak...ImageRead Article Now Book Mark Article Outlook (Prognosis) Outlook depends on the cause.People with AD due to a medicine usually recover when that medicine is stopped. When AD is caused by other factors, recovery depends on how well the disease can be treated. Possible Complications Complications may occur due to side effects of medicines used to treat the condition. Long-term, severe high blood pressure may cause seizures, bleeding in the eyes, stroke, or death. When to Contact a Medical Professional Contact your provider right away if you have symptoms of AD. Prevention To prevent AD, do not take medicines that cause this condition or make it worse. In people with spinal cord injury, the following may also help prevent AD:Do not let the bladder become too full Pain should be controlled Practice proper bowel care to avoid stool impaction Stool impactionA fecal impaction is a large lump of dry, hard stool that stays stuck in the rectum. It is most often seen in people who are constipated for a long ...ImageRead Article Now Book Mark Article Practice proper skin care to avoid bedsores and skin infections Prevent bladder infections Open ReferencesReferencesCheshire WP. Autonomic disorders and their management. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 390.Cowan H. Autonomic dysreflexia in spinal cord injury. Nurs Times. 2015;111(44):22-24. PMID: 26665385 pubmed.ncbi.nlm.nih.gov/26665385/.Khanna R, Fessler RD, Snyder L, Fessler RG. Spinal cord trauma. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 63.McDonagh DL, Barden CB. Autonomic dysreflexia. In: Fleisher LA, Rosenbaum SH, eds. Complications in Anesthesia. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 131.AllVideoImagesTogCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.Central nervous system and peripheral nervous systemillustrationCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.Central nervous system and peripheral nervous systemillustrationRelated Information Review Date: 5/2/2022 Reviewed By: Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. 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Autonomic dysreflexiaAutonomic hyperreflexia; Spinal cord injury - autonomic dysreflexia; SCI - autonomic dysreflexiaAutonomic dysreflexia is an abnormal, overreaction of the involuntary (autonomic) nervous system to stimulation. This reaction may include: Change in heart rate Excessive sweating High blood pressure Muscle spasms Skin color changes (paleness, redness, blue-gray skin color) Causes The most common cause of autonomic dysreflexia (AD) is spinal cord injury. The nervous system of people with AD over-responds to the types of stimulation that do not bother healthy people.Other causes include: Guillain-Barré syndrome (disorder in which the body's immune system mistakenly attacks part of the nervous system) Guillain-Barré syndromeGuillain-Barré syndrome (GBS) is a serious health problem that occurs when the body's defense (immune) system mistakenly attacks part of the peripher...ImageRead Article Now Book Mark Article Side effects of some medicines Severe head trauma and other brain injuries Subarachnoid hemorrhage (a form of brain bleeding) Subarachnoid hemorrhageSubarachnoid hemorrhage is bleeding in the area between the brain and the thin tissues that cover the brain. This area is called the subarachnoid sp...Read Article Now Book Mark Article Use of illegal stimulant drugs such as cocaine and amphetamines Symptoms Symptoms can include any of the following:Anxiety or worry Bladder or bowel problems Blurry vision, widened (dilated) pupils Lightheadedness, dizziness, or fainting Fever Goosebumps, flushed (red) skin above the level of the spinal cord injury Heavy sweating High blood pressure Irregular heartbeat, slow or fast pulse Muscle spasms, especially in the jaw Nasal congestion Throbbing headacheSometimes there are no symptoms, even with a dangerous rise in blood pressure. Exams and Tests The health care provider will do a complete nervous system and medical examination. Tell the provider about all the medicines you are taking now and that you took in the past. This helps determine which tests you need.Tests may include:Blood and urine tests CT or MRI scan CTA computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...ImageRead Article Now Book Mark Article MRI scanA magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...ImageRead Article Now Book Mark Article ECG (measurement of the heart's electrical activity) ECGAn electrocardiogram (ECG) is a test that records the electrical activity of the heart.ImageRead Article Now Book Mark Article Lumbar puncture Lumbar punctureCerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...ImageRead Article Now Book Mark Article Tilt-table testing (testing of blood pressure as the body position changes) Toxicology screening (tests for any drugs, including medicines, in your bloodstream) X-rays Other conditions share many symptoms with AD, but have a different cause. The exam and testing help the provider rule out these other conditions, including:Carcinoid syndrome (tumors of the small intestine, colon, appendix, and bronchial tubes in the lungs) Carcinoid syndromeCarcinoid syndrome is a group of symptoms associated with carcinoid tumors. These are tumors most often of the small intestine, colon, appendix, or ...ImageRead Article Now Book Mark Article Neuroleptic malignant syndrome (a condition caused by some medicines that leads to muscle stiffness, high fever, and drowsiness) Pheochromocytoma (tumor of the adrenal gland) PheochromocytomaPheochromocytoma is a rare tumor of adrenal gland tissue. It results in the release of too much epinephrine and norepinephrine, hormones that contro...ImageRead Article Now Book Mark Article Serotonin syndrome (drug reaction that causes the body to have too much serotonin, a chemical produced by nerve cells) Serotonin syndromeSerotonin syndrome (SS) is a potentially life-threatening drug reaction. It causes the body to have too much serotonin, a chemical produced by some ...Read Article Now Book Mark Article Thyroid storm (life-threatening condition from an overactive thyroid) Thyroid stormThyroid storm is a rare life-threatening condition of the thyroid gland. It develops in cases of untreated hyperthyroidism, or overactive thyroid (t...ImageRead Article Now Book Mark Article Treatment AD is life threatening, so it is important to quickly find and treat the problem.A person with symptoms of AD should:Sit up and raise the head Remove tight clothingProper treatment depends on the cause. If medicines or illegal drugs are causing the symptoms, those drugs must be stopped. Any illness needs to be treated. For example, the provider will check for a blocked urinary catheter and signs of constipation which may cause AD in someone with a spinal cord injury.If a slowing of the heart rate is causing AD, drugs called anticholinergics (such as atropine) may be used.Very high blood pressure needs to be treated quickly but carefully, because the blood pressure can drop suddenly.A pacemaker may be needed for an unstable heart rhythm.PacemakerA pacemaker is a small, battery-operated device. This device senses when your heart is beating too slowly. It sends a signal to your heart that mak...ImageRead Article Now Book Mark Article Outlook (Prognosis) Outlook depends on the cause.People with AD due to a medicine usually recover when that medicine is stopped. When AD is caused by other factors, recovery depends on how well the disease can be treated. Possible Complications Complications may occur due to side effects of medicines used to treat the condition. Long-term, severe high blood pressure may cause seizures, bleeding in the eyes, stroke, or death. When to Contact a Medical Professional Contact your provider right away if you have symptoms of AD. Prevention To prevent AD, do not take medicines that cause this condition or make it worse. In people with spinal cord injury, the following may also help prevent AD:Do not let the bladder become too full Pain should be controlled Practice proper bowel care to avoid stool impaction Stool impactionA fecal impaction is a large lump of dry, hard stool that stays stuck in the rectum. It is most often seen in people who are constipated for a long ...ImageRead Article Now Book Mark Article Practice proper skin care to avoid bedsores and skin infections Prevent bladder infections Open ReferencesReferencesCheshire WP. Autonomic disorders and their management. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 390.Cowan H. Autonomic dysreflexia in spinal cord injury. Nurs Times. 2015;111(44):22-24. PMID: 26665385 pubmed.ncbi.nlm.nih.gov/26665385/.Khanna R, Fessler RD, Snyder L, Fessler RG. Spinal cord trauma. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 63.McDonagh DL, Barden CB. Autonomic dysreflexia. In: Fleisher LA, Rosenbaum SH, eds. Complications in Anesthesia. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 131.