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Autonomic dysreflexia

What is autonomic dysreflexia?

Autonomic dysreflexia, also called „Gutmann-Reflex“, is a regulation problem that leads to an over-stimulation of the autonomic nervous system. In case of a spinal cord injury (SCI), this may occur above the seventh, rarely also the eighth thoracic vertebra.
Autonomic dysreflexia can be triggered through various stimuli, mostly through stimuli in the bladder or bowel area. These stimuli are causing an uncontrolled spasmodic contraction of the vessels below the lesion level. As a consequence, the blood pressure increases rapidly and the symptoms described below may arise. The brain notices that the blood pressure is way too high and tries to lower the blood pressure by reducing the heart rate.

Signs of an autonomic dysreflexia

  • pulsating or hammering headache
  • vertigo
  • sweating
  • facial flushing
  • low pulse rate
  • massive and very sudden increase of blood pressure

What may be the causes?

Important

Do not ignore the symptoms! If not treated properly, they may lead to seizures, unconsciousness or stroke.

How to react?

The most important measure is to eliminate the cause:

  • If this is not the case and symptoms persist, try flushing the catheter; if this is not possible, the catheter needs to be exchanged immediately.

If the bladder is empty:

  • Check whether the bowel is full and, if necessary, empty bowel.
  • Change sitting or lying position to check whether there is an object hidden under the buttocks/body.

Important

If the reason cannot be identified, contact your GP immediately!

FAQs

Can the bladder be emptied normally through triggering if I have an autonomic dysreflexia?
Normally not. The bladder has to be emptied as soon as possible using a disposable catheter.

What do I need to consider if I am pregnant?
Women with spinal cord injury (SCI) may suffer from autonomic dysreflexia when giving birth. Not all gynecologists are confident with this condition and it is therefore important to discuss it with the physician.

About the authors:

  • Karin Roth is advanced practice nurse in the Department for Nursing Development and Education at the Swiss Paraplegic Centre in Nottwil/Switzerland, where she has worked since 1997. She is co-author of the key publication in the field of spinal cord injury "Pflege von Menschen mit Querschnittlähmung" (ed. Ute Haas).
  • Christa Schwager is a specialist in movement science in the Department for Nursing Development and Education at the Swiss Paraplegic Centre, where she has worked since 1994. She is co-author of the key publications in the field of spinal cord injury "Pflege von Menschen mit Querschnittlähmung" and "Paraplegie. Ganzheitliche Rehabilitation" (eds. Guido A. Zäch & Hans Georg Koch).


updated: December 2013

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