autonomic dysreflexia


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Related to autonomic dysreflexia: autonomic nervous system, Spinal shock, Autonomic dysfunction

autonomic

 [aw″to-nom´ik]
not subject to voluntary control.
autonomic dysreflexia an uninhibited and exaggerated reflex of the autonomic nervous system to stimulation; called also hyperreflexia. The response occurs in 85 per cent of all patients who have spinal cord injury above the level of the sixth thoracic vertebra. It is potentially dangerous because of attendant vasoconstriction and immediate elevation of blood pressure, which in turn can bring about hemorrhagic retinal damage or stroke syndrome. Less serious effects include severe headache; changes in heart rate; sweating, flushing, and “goose bumps” or piloerection above the level of the spinal cord injury; and pallor below that level.
Patient Care. Circumstances that can trigger autonomic dysreflexia are often related to stimulation of the bladder, bowel, and skin of the patient. Examples are a distended bowel or bladder, pressure on the skin, or any of a number of noxious stimuli.

Once the symptoms of autonomic dysreflexia are manifest, emergency care is indicated. Efforts are made to lower the blood pressure by placing the patient in a sitting position or elevating the head and upper body to a 45-degree angle. The stimulus must be identified and removed as gently and quickly as possible. If fecal impaction is the cause, the rectum should be coated with an anesthetic ointment prior to attempted removal of the impaction; this prevents increasing the stimulus to autonomic dysreflexia. The physician is notified so that appropriate medical intervention can be initiated. Antihypertensive drugs are a last resort. As soon as the cause is identified and removed, the dysreflexia will disappear. Patients who experience repeated attacks may require surgery to sever the nerves responsible for the exaggerated response to stimulation.
autonomic nervous system the branch of the nervous system that works without conscious control. The voluntary nervous system governs the striated or skeletal muscles, whereas the autonomic nervous system governs the glands, cardiac muscle, and smooth muscles such as those of the digestive system, respiratory system, and skin. The autonomic nervous system is divided into two subsidiary systems, the sympathetic nervous system and the parasympathetic nervous system. See Plate 14.

dysreflexia

 [dis″re-flek´se-ah]
a condition of disordered response to stimuli.
autonomic dysreflexia
1. an uninhibited and exaggerated response of the autonomic nervous system to stimulation, as seen in many patients with high spinal cord injuries; see also autonomic dysreflexia.
2. a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as a life-threatening uninhibited sympathetic response of the nervous system to a noxious stimulus after a spinal cord injury at T7 or above.

autonomic dysreflexia

a syndrome affecting persons with a spinal cord lesion above the midthoracic level (tetraplegics and some paraplegics) that is characterized by hypertension, bradycardia, severe headaches, pallor below and flushing above the cord lesions, and convulsions. It is the result of impaired function of the autonomic nervous system caused by simultaneous sympathetic and parasympathetic activity, such as may occur with bowel or bladder distension pain or a pressure ulcer. It is usually a medical emergency requiring care in an intensive care unit. A cerebrovascular accident and death may occur during an attack. See also autonomic hyperreflexia.

autonomic dysreflexia

A potentially life-threatening condition most common in patients with spinal cord injuries above T6, but which may occur with lesions as low as T10.

Clinical findings
Severe paroxysmal hypertension accompanied by throbbing headaches, profuse sweating, nasal stuffiness, flushing of the skin above thelesion, bradycardia, apprehension and anxiety.

autonomic dysreflexia

Neurology A potentially life-threatening ↑ in BP, sweating, and other autonomic reflexes in reponse to various stimuli–eg, bowel impaction. See Autonomic failure.

au·to·no·mic dys·re·flex·ia

(aw'tō-nom'ik dis-rē-flek'sē-ă)
A syndrome occurring in some people with spinal cord lesions resulting from functional impairment of the autonomic nervous system. Symptoms include hypertension, bradycardia, severe headaches, pallor below and flushing above the cord lesion, and convulsions.
Synonym(s): autonomic hyperreflexia.
[G. autos, self + nomos, law; dys, difficult at + L. reflectere, to bend back]

au·to·no·mic dys·re·flex·ia

(aw'tō-nom'ik dis-rē-flek'sē-ă)
A syndrome occurring in some people with spinal cord lesions resulting from functional impairment of the autonomic nervous system.
References in periodicals archive ?
Evidence of autonomic dysreflexia during functional electrical stimulation in individuals with spinal cord injuries.
Key Words: autonomic dysreflexia, paraplegia, quadriplegia, anterior spinal thrombosis
Autonomic dysreflexia is an abnormal reflex which occurs in people with spinal cord injuries at the level of T6 and above.
Autonomic dysreflexia has not yet claimed the lives of any disabled sportsmen, although in a non-sporting context, deaths, brain haemorrhages, strokes and heart attacks have been reported from those quadraplegics in whom it occurs naturally.
For the most part, autonomic dysreflexia can be prevented.
Unfortunately, confusion of autonomic dysreflexia with preeclampsia[5] still occurs and the gynecologist who works with a woman with spinal cord injury must be able to differentiate between these two conditions in order to properly treat dysreflexia in the woman with spinal cord injury.
Incidence and clinical features of autonomic dysreflexia in patients with spinal cord injury.
This paper addresses an important, yet poorly appreciated area of spinal cord injury, noting the potential for maladaptive neuroplastic changes in the chronic stages of injury that can contribute to autonomic dysreflexia," says John T.
autonomic dysreflexia, bradycardia, and orthostatic hypotension) and higher risk for cardiovascular diseases [1-2].
True (A) or false (B)--fill in only block A or B: Faecal impaction is the most common cause of autonomic dysreflexia in spinal cord injury.
In addition, the cardiovascular and metabolic alterations secondary to these neurological impairments (SCI, TBI, and MS) involving the autonomic nervous system [17-19] could hinder the compensatory mechanisms, causing an increase in the severity of the symptoms, particularly in those with tetraplegia because they may experience autonomic dysreflexia.

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