Author Credentials

Apurva Bhatt, MSVI, Brit Moore, MD, Talal Asif, MD, Kristy E. Steigerwalt, PharmD, M.L.S, Rebecca R. Pauly, MD




Autonomic dysreflexia (AD) is a life threatening condition affecting patients with spinal cord lesions T6 level and above. A 51 year old male with a history of paraplegia due to a C6 spinal cord injury (30 years prior) presented with recurrent debilitating episodic diaphoresis, hypertension, low body temperature, and bradycardia. Previous hospitalizations presumed sepsis from UTI to be the etiology, however on further evaluation his symptoms were consistent with undiagnosed AD. This article describes a unique case presentation and reviews AD in depth, including the etiology, pathophysiology and management.

Conflict(s) of Interest


References with DOI

1. Bycroft J, Shergill IS, Chung EAL, Arya N, Shah PJ. Autonomic dysreflexia: a medical emergency. Postgrad Med Journal. 2005;81(954):232-5. https://doi.org/10.1136/pgmj.2004.024463

2. Kirshblum S, Gonzalez, P, Nieves, J, Cuccurullo S, Luciano. Spinal cord injuries. In: Cuccurullo, S, editor. Physical medicine and rehabilitation board review. 2nd ed. New York NY: Demos Medical Publishing; 2010. pp. 562-73.

3. Phillips AA, Krassioukov, AV. Contemporary cardiovascular concerns after spinal cord injury: mechanisms, maladaptations and management. J Neurotrauma. 2015;32:1927-42. https://doi.org/10.1089/neu.2015.3903

4. Shergill IS, Arya M, Hamid R, Khastgir J, Patel HR, Shah PJ. The importance of autonomic dysreflexia to the urologist. BJU Int. 2004;93:923–6. https://doi.org/10.1111/j.1464-410x.2003.04756.x

5. Karlsson AK. Autonomic dysreflexia. Spinal Cord. 1999;37:383–91.

6. Cruz ES, Stolzenberg D, Moon D, Maitin IB, Cruz E. Medical emergencies in rehabilitation medicine. In: Maitin IB Cruz E editors. Current Diagnosis & Treatment: Physical Medicine & Rehabilitation. New York NY: McGraw-Hill; 2015. pp. 96,587.

7. Colachis III, Sam C. Hypothermia associated with autonomic dysreflexia after traumatic spinal cord injury. American Journal of Physical Medicine & Rehabilitation. 2002;81(3):232-5. https://doi.org/10.1097/00002060-200203000-00013

8. Hagen, EM. Acute complications of spinal cord injuries. World Journal of Orthopedics. 2015;6(1):17-23. https://doi.org/10.5312/wjo.v6.i1.17