How To Manage Autonomic Dysreflexia

This article contains a video
Written by
Brittany Déjean
Content via Christopher & Dana Reeve Foundation
Christopher & Dana Reeve Foundation
Written by
Brittany Déjean

Autonomic dysreflexia (AD) is a serious condition that affects individuals with spinal cord injuries (typically those with a T6 level or higher spinal cord injury).

When an AD episode occurs, it must be addressed immediately. If left untreated, it could lead to a stroke or even death; therefore, those with spinal cord injuries and anyone who cares for an individual with SCI must understand this important subject.

What Is Autonomic Dysreflexia (AD)?

“AD is a rise in blood pressure that people with spinal cord injuries get when they have a pain stimulus somewhere below their lesion,” explains Dr. Steven Steins. When a pain stimulus travels up the spinal cord, it is unable to reach the brain because it stops at the injury location. And the brain is therefore unable to get a message back down to the pain stimulus to modulate the situation and bring down blood pressure.

As a result, blood pressure escalates, often rapidly.

What Causes Autonomic Dysreflexia (AD)?

Bladder and bowel blockages are the most common causes of AD. Other causes can be skin issues such as breakdowns, pressure sores, or burns.  Ingrown toenails can also cause AD. In women, menstruation can bring on AD as well.

What are the Symptoms of Autonomic Dysreflexia (AD)?

  • High Blood Pressure (usually 20mm to 40 mm Hg above normal blood pressure)
  • Increased Spasms
  • Goosebumps
  • Sweating (above the level of injury)
  • Pounding Headache

How is Autonomic Dysreflexia (AD) Alleviated?

Sit up as straight as you can. If in bed, elevate your head so you are sitting upright. This will help your blood pressure begin to lower.

Find the cause and take action. For example, if you catheter is clogged, change it immediately. If it’s been a while since you’ve had a bowel movement, begin your bowel program right away.

In most instances, you (or an assistant) will need to identify and relieve the symptoms in order to alleviate the AD episode. Medical professionals are oftentimes unfamiliar with AD, and may not know the appropriate action to take.

You can request or download a free AD Wallet Card (cards are available for both adults and children).

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