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         Autonomic Dysreflexia:     more detail
  1. Autonomic Dysreflexia: What You Should Know- Consumer Guide
  2. Neurologic Emergencies with CDROM

41. WEBFILES\AUTO-DYSREFLEXIA
Spinal Cord Injury autonomic dysreflexia autonomic dysreflexia. Autonomicdysreflexia autonomic response. Symptoms of autonomic dysreflexia.
http://users.sgi.net/~ozzy/auto-dys.htm
Spinal Cord Injury: Autonomic Dysreflexia Autonomic Dysreflexia Autonomic dysreflexia is a life threatening complication of high thoracic and cervical spinal cord injuries. It occurs when a Spinal Cord Injury (SCI) is above the area of T5 and T6. An SCI above this area separates the sympathetic and parasympathetic branches of the Autonomic Nervous System (ANS), by disconnecting the feedback loop between these two branches. The sympathetic and parasympathetic branches have a similar role between each other; as one is activated, the other is suppressed in a negative feedback system, and without this feedback loop the branches function independently from one another, and any irritation below the level of injury stimulates an unopposed autonomic response. For example, a full bladder can stimulate the sympathetic system with no opposition from the parasympathetic system because it cannot cross the lesion in the spinal cord, because of this opposition the systolic blood pressure can rise and cause cerebral hemorrhage or even death, which is the unopposed autonomic response.
Symptoms of autonomic dysreflexia When the blood pressure rises the carotid bodies in the neck detect this, and they stimulate a parasympathetic response of what's called vasodilation above the level of injury, which causes the symptoms to appear above the level of injury, such as headache, sweating, flushing, and bradycardia. If the condition is left untreated it can cause a stroke, cardiac arrest, blindness, or even death.

42. Autonomic Dysreflexia
autonomic dysreflexia. This article submitted by Michael on 10/11/97. Email AddressWhen I had my spinal cord injury, I was warned about autonomic dysreflexia.
http://neuro-www.mgh.harvard.edu/forum/AutonomicF/10.11.9710.29PMAutonomicDysref
Autonomic Dysreflexia
This article submitted by Michael on 10/11/97.
Email Address:
When I had my spinal cord injury, I was warned about autonomic dysreflexia. This is a condition in which the blood pressure soars and you get a clammy feeling, perhaps with sweating. I was told to use a catheter immediately, since the condition is often associated with a full bladder. I've had only a few episodes, some of them under great stress, e.g. while having a myelogram. A dose of ProCardia under the tongue has taken care of the blood pressure. I'd like to hear of others' experiences along this line. Next Article
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43. Autonomic Dysreflexia In Women
No messages are screened for content. autonomic dysreflexia in women. This articlesubmitted by on 12/22/99. autonomic dysreflexia hormones (12/30/99) 843 PM.
http://neuro-www.mgh.harvard.edu/forum_2/SpinalCordInjuryF/12.22.993.03PMAutonom
This Web Forum is not moderated in any sense. Anyone on the Internet can post articles or reply to previously posted articles, and they may do so anonymously. Therefore, the opinions and statements made in all articles and replies do not represent the official opinions of MGH and MGH Neurology. Neither is MGH or MGH Neurology responsible for the content of any articles or replies. No messages are screened for content.
Autonomic Dysreflexia in women
This article submitted by on 12/22/99.
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Has any woman with a spinal cord injury (paraplegia) ever had autonomic dysreflexia that may have been caused by menopause (disruption of hormone levels). Any information would be very much appreciated. Next Article
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  • 44. Autonomic Dysreflexia
    autonomic dysreflexia. If your injury is above T8, you are at riskfor developing autonomic dysreflexia. It is caused by an annoying
    http://www.physicaltherapy.ca/neuro/sci-autodys.html
    Autonomic Dysreflexia
    If your injury is above T8, you are at risk for developing autonomic dysreflexia. It is caused by an annoying stimulus below the level of the lesion and causes an increase in your blood pressure. This increase in blood pressure can cause dizziness, severe headaches, sweating, goose bumps, blurred vision, and a sick feeling. It is a medical emergency!
    Examples of annoying stimuli that can cause autonomic dysreflexia are pressure sores, a full bladder, or temperature changes.

    45. Www.RehabTrials.org - Feature Article
    page 1, 2 Trevor DysonHudson, MD A good example is autonomic dysreflexia.autonomic dysreflexia is an acute syndrome that can
    http://www.rehabtrials.org/fa/fa_tdyson-hudson032300_p2.php3
    Clinical trials in acupuncture and spinal cord injury: what is the risk of complication?
    Trevor Dyson-Hudson, M.D.
    A good example is autonomic dysreflexia. Since needle acupuncture involves the insertion of fine needles into the skin, should people be concerned that it may produce autonomic dysreflexia in individuals with SCI? Very little has been reported on the topic of acupuncture and autonomic dysreflexia in SCI. Rapson and associates (need a pop-up of a PubMed citation here - Rapson LM, Biemann IM, Bharatwai ND, Pepper J, Mustard BE. Acupuncture in the treatment of pain in SCI. J Spinal Cord Med 1995 18:133.) observed no complications while investigating needle acupuncture on SCI subjects. With increased interest in the use of acupuncture on clinical populations, how do we address the risk of autonomic dysreflexia? While autonomic dysreflexia is always a concern, not everyone is at a substantial risk for complications. As a safety precaution, however, clinical trial conduct should be modified to watch for the tell tale signs of trouble. Awareness of the risk of autonomic dysreflexia in SCI subjects, combined with monitoring of associated symptoms such as headache, nasal stuffiness, flushing of the skin, sweating, pallor, or piloerection should be enough to safeguard against the occurrence of this condition in most circumstances.

    46. GoGuides.Org Directory | Autonomic Dysreflexia
    Health Fitness Disabilities Disorders Conditions Diseases NervousSystem Disorders Autonomic Nervous System Disease autonomic dysreflexia
    http://www.goguides.org/index.php/viewCat/13455

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      eMedicine: Autonomic Dysreflexia in Spinal Cord Injury
      - Presented is a clinical report authored by Denise I Campagnolo, MD, MS, Clinical Director of Spinal Cord Injury Program, Associate Professor, Department of Physical Medicine and Rehabilitation, New Jersey Medical School.
      URL: http://www.emedicine.com/pmr/topic217.htm Northeast Rehabilitation: Autonomic Dysreflexia - Offers an explanation as to what this is, the signs and symptoms, causes, management of an episode, and prevention.
      URL: http://www.northeastrehab.com/Articles/dysreflexia.htm NSCIA: Autonomic Dysreflexia - National Spinal Cord Injury Association presents a factsheet about AD, a complication of spinal cord injury.
      URL: http://www.spinalcord.org/resource/Factsheets/factsheet17.html
    < Previous Pages: Next >> Guide needed for this topic. Apply to edit this category Link To GoGuides Advertising ... GoGuide Profiles © 2003 GoGuides.Org. Registration Pending

    47. Page12
    autonomic dysreflexia and Some Causes. autonomic dysreflexia parasympatheticdivisions. autonomic dysreflexia concerns the sympathetic division.
    http://djepson.wiredup.com/dysreflexia.html
    Autonomic dysreflexia and Some Causes Autonomic dysreflexia, or hyperreflexia, is a massive uncompensated cardiovascular reaction of the sympathetic division of the autonomic nervous system to visceral stimulation that occurs in clients with spinal cord lesions above T6. The autonomic nervous system is the part of the nervous system that is concerned with control of involuntary bodily functions. It regulates the function of glands, especially the salivary, gastric, and sweat glands, and the adrenal medulla; smooth muscle tissue; and the heart. The autonomic nervous system may act on these tissues to reduce or slow activity or to initiate their function. It is divided into the sympathetic and parasympathetic divisions. Autonomic dysreflexia concerns the sympathetic division. Stimulating sympathetic fibers usually produces vasoconstriction in the part supplied, general rise in blood pressure, erection of body hair, goose-flesh, pupillary dilation, secretion of small quantities of thick saliva, depression of gastrointestinal activity, and acceleration of the heart. In general these activities occur under emergencies such as fright and are associated with the expenditure of energy as a response to the need to either flee, fight, or to be frightened. They are mediated through the release of a transmitter agent, norepinephrine. The condition of autonomic dysreflexia can be a life-threatening situation that requires immediate resolution.

    48. 1Up Health > Health Links Directory > Conditions And Diseases: Neurological Diso
    Sites. AD Fact Sheet An article explaining what autonomic dysreflexiais and how it occurs. Paralyzed Veterans of America A consumer
    http://www.1uphealth.com/links/autonomic-nervous-system-autonomic-dysreflexia.ht
    Home Contact Us Privacy Caring For Your Well Being Alternative Medicine Clinical Trials Health News Poisons ... Health Topics A-Z Search 1Up Health
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    ... Autonomic Nervous System : Autonomic Dysreflexia Description
    See Related Categories Health: Conditions and Diseases: Neurological Disorders: Trauma and Injuries: Spinal Cord Injury
    Sites AD Fact Sheet
    An article explaining what autonomic dysreflexia is and how it occurs. Paralyzed Veterans of America A consumer guide to autonomic dysreflexia, what should be known. For down load on PDF. RehabNET Monographs A description of Autonomic dysreflexia, including the signs and symptoms, the causes, management and prevention. Spinal Cord Injury Information Details about autonomic dysreflexia, the symptoms and why they happen and finding and removing the causes. Help build the largest human-edited directory on the web. Submit a Site Open Directory Project Become an Editor Parts of the directory made available on 1UpHealth have been modified. External Web site links provided on this site are meant for convenience and for informational purposes only; they do not constitute an endorsement.

    49. ParaDoc - International Spinal Cord Documentation And Referral Centre For Educat
    Catalogue Current Search Formulation autonomic dysreflexia . Title in English,Author, Year, Language, Details. autonomic dysreflexia what you should know.
    http://www.paradoc.org/html/result0.asp?KeyWords=autonomic dysreflexia

    50. Spinal Cord Injury Health Issues
    autonomic dysreflexia (HYPERREFLEXIA). Also, the older the injury theless likely the person will experience autonomic dysreflexia.
    http://spinaltimes.org/hl_prevent.htm

    AUTONOMIC DYSREFLEXIA (HYPERREFLEXIA)
    HETEROTOPIC OSSIFICATION (HO)/CYST HYPERTHERMIA/HYPOTHERMIA DEEP VENOUS THROMBOSIS (DVT) ... POSTURAL (ORTHOSTATIC) HYPOTENSION AUTONOMIC DYSREFLEXIA (HYPERREFLEXIA) Prevention of autonomic dysreflexia is very important. The following are precautions you can take which may prevent episodes: If you have an indwelling catheter, keep the tubing free of kinks, keep the drainage bags empty and check daily for grits (deposits) inside of the catheter. If you are on an intermittent catheterization program, catheterize yourself as often as necessary to prevent overfilling. If you have spontaneous voiding, make sure you have an adequate output. Also, maintain a regular bowel program and perform daily skin assessments. Back to Top HETEROTOPIC OSSIFICATION (HO)/CYST Back to Top HYPERTHERMIA/HYPOTHERMIA Back to Top DEEP VENOUS THROMBOSIS (DVT) Some patients with SCI develop deep venous thrombosis (DVT), or clots in the veins that sometimes give rise to clots in the lungs. Possible signs and symptoms of DVT include swelling of the leg, dilation of the veins, increased skin temperature, pain and tenderness, and, rarely, a bluish discoloration of the lower leg. Sometimes, there are no signs and symptoms of DVT. There are also no characteristic signs or symptoms of lung clots, meaning the signs and symptoms are very nonspecific, such as fever, chest pain, cough, or changes in heart beat. Although other measures are sometimes used, the most common form of treatment for DVT is the use of anticoagulants, such as heparin and warfarin.

    51. APStracts 4:0586H, 1997.
    Does postsynaptic angstroma1adrenergic receptor supersensitivitycontribute to autonomic dysreflexia?. Landrum, Lisa M., Gerald
    http://oac3.hsc.uth.tmc.edu/apstracts/1997/heart/December/586H.html
    Does postsynaptic [angstrom]a1-adrenergic receptor supersensitivity contribute to autonomic dysreflexia?. Landrum, Lisa M., Gerald M. Thompson, and Robert W. Blair. Department of Physiology; University of Oklahoma Health Sciences Center APStracts 4:0586H, 1997.

    52. Autonomic Hyperreflexia
    Images(Click to view larger image) Autonomic nervous system Alternative Namesautonomic dysreflexia, dysreflexia, hyperreflexia Definition Autonomic
    http://www.jewishhospital.org/healthinfo/encyclopediaHTML/538.html

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    ... Special Topics Autonomic hyperreflexia Images (Click to view larger image)
    Alternative Names
    autonomic dysreflexia, dysreflexia, hyperreflexia
    Definition
    Autonomic hyperreflexia is an abnormal triggering of the autonomic nervous system. It occurs after a spinal cord injury . The body is unable to turn off the nerves that cause blood pressure to rise. What is going on in the body? Normally, the autonomic nervous system controls blood pressure automatically. It does this by commanding muscles around blood vessels to tighten or relax in order to raise or lower blood pressure. The nervous system can monitor blood pressure and continually adjusts the commands to keep blood pressure normal. When a person has a spinal cord injury , it can cause damage to nerves in the spinal cord. And this results in a loss of control in the nerves. This can happen if the damage to the spinal cord is in the neck or upper back. The bones of the spine are each labeled and numbered. Damage at the 6th thoracic bone or higher means the person may develop this problem. If the damage is lower, autonomic hyperreflexia will not be a problem.

    53. Transverse Myelitis Internet Club List: Autonomic Dysreflexia
    autonomic dysreflexia. James Lubin (jlubin@eskimo.com) Sat, 05 Apr1997 192723 0800 autonomic dysreflexia. autonomic dysreflexia
    http://www.myelitis.org/tmic/archive/6/0143.html
    Autonomic Dysreflexia
    James Lubin ( jlubin@eskimo.com
    Sat, 05 Apr 1997 19:27:23 -0800
    Autonomic Dysreflexia
    Autonomic dysreflexia (AD) is a condition that can occur in anyone who has
    a spinal cord injury at or above the T6 level. It is related to
    disconnections between the body below the injury and the control mechanisms
    for blood pressure and heart function. It causes the blood pressure to rise
    to potentially dangerous levels.
    AD can be caused by a number of things. The most common causes are a full
    bladder, bladder infection, severe constipation, or pressure sores.
    Anything that would normally cause pain or discomfort below the level of
    the spinal cord injury can trigger dysreflexia. AD can occur during medical tests or procedures and need to be watched for. The symptoms that occur with AD are directly related to the types of responses that happen in the sympathetic and parasympathetic nervous systems. Symptoms such as a pounding headache, spots before the eyes, or

    54. Welcome To The Spinal Injuries Association
    What is autonomic dysreflexia ? autonomic dysreflexia emergency. Whatare signs and symptoms of autonomic dysreflexia? · Hypertension
    http://www.spinal.co.uk/about/default.ihtml?pid=24&step=2

    55. 2000 INJURY PREVENTION RESEARCH GRANTS
    An antisense therapy targeting NR2D mRNA as a treatment for autonomic dysreflexia.autonomic dysreflexia is a condition wherein individuals
    http://www.onf.org/grantrecip/00bgrant24.htm
    Pierre A. G. Mattar (Studentship)
    John P. Robarts Research Institute, London
    $40,000 over two years
    An antisense therapy targeting NR2D mRNA as a treatment for autonomic dysreflexia
    Autonomic dysreflexia is a condition wherein individuals experience recurring episodes of high blood pressure that can cause debilitating headaches or even strokes, seizures, abnormal heart rhythms, and death. Following spinal cord injury (SCI), development of autonomic dysreflexia is prevalent. Autonomic dysreflexia has been shown to result from over-activity of a specific set of nerve cells in the spinal cord termed sympathetic preganglionic neurons (SPNs). SPNs are activated when glutamate neurotransmitters are released from cells and bind to their NMDA receptors (NMDARs) on the surface of SPNs . Excess glutamate is known to be released following SCI. In this study, the research group will attempt to reduce the production of NMDARs to prevent over-activity of SPNs and, therefore, reduce autonomic dysreflexia . This research involves infecting SPNs with a non-hazardous virus with the aim of occupying the cell’s machinery with trying to replicate the harmless virus instead of producing other cellular proteins such as NMDARs.

    56. 2001 INJURY PREVENTION RESEARCH GRANTS
    autonomic dysreflexia is a condition wherein individuals experience episodes ofhigh blood pressure that can cause debilitating headaches or even strokes
    http://www.onf.org/grantrecip/01bgrant07.htm
    Denis Gris
    John P. Robarts Research Institute, London
    $60,000 over three years (Studentship) Mechanisms for Pain after SCI
    Autonomic dysreflexia is a condition wherein individuals experience episodes of high blood pressure that can cause debilitating headaches or even strokes, seizures, abnormal heart rhythms, and death. Following SCI, development of autonomic dysreflexia and chronic pain is prevalent. The objective of this research is to delineate mechanisms for autonomic dysreflexia. After SCI, there is an inflammation response whereby biological factors that serve to attract immune system cells, that will uptake debris, are released. While the inflammation response is important to the recovery process, this research group hypothesizes that after SCI, the inflammation response is the cause of autonomic dysreflexia. They will test this hypothesis by assessing whether use of an antibody against immune cells prevents the development of autonomic dysreflexia. Positive outcomes from this study may lead to the development of novel and improved treatments for preventing pain following SCI.
    Click to Return to Listing of 2001 Biomedical Research Funding Recipients

    57. ARN Continuing Education Information
    autonomic dysreflexia A Clinical Rehabilitation Problem, Patricia L. Travers,MS RN, Key words autonomic dysreflexia, hyperreflexia, spinal cord injury.
    http://www.rehabnurse.org/ce/010299/auto.htm
    Autonomic Dysreflexia: A Clinical Rehabilitation Problem Patricia L. Travers, MS RN Key words
    autonomic dysreflexia, hyperreflexia, spinal cord injury Autonomic dysreflexia, or hyperreflexia, is a life-threatening condition that can occur in a person with a spinal cord injury at or above the T6 level. The classic signs and symptoms are severe hypertension, pounding headache, and diaphoresis. Prevention is the key to avoiding this disease process. This article reviews the pathophysiology, precipitating factors, signs and symptoms, nursing management, and effects of the problem. All healthcare providers must be aware of this condition in order to prevent permanent impairments in clients who may experience it.
    Patricia Travers is a nursing coordinator on the medical rehabilitation unit of DeGraff Memorial Hospital, CGF Health System, in North Tonawanda, NY. Address correspondence to Patricia L. Travers, 2880 Albright Road, Ransomville, NY 14131, e-mail mptrav@aol.com

    Epidemiology
    According to The National Spinal Cord Injury Association (1996), approximately 7,800-12,600 new cases of SCI occur annually in the United States. In 1996, the number of people with an SCI or spinal dysfunction at any given time was assessed to be 250,000-400,000. Estimates are that 8% of people with SCI are institutionalized after they have been discharged from the hospital (The National Spinal Cord Injury Association).
    Pathophysiology
    The PANS and SANS exit at different sites in the CNS (see Figure 1
    In a client with a high-level SCI, intact lower motor neurons sense the painful stimuli below the level of injury and transmit the message up the spinal cord (see

    58. Spinalsoothers.com - Medical Emergencies
    Only if you have a spinal cord lesion above T6 are you prone to autonomic dysreflexiaor hyperreflexia. How will I know that I have autonomic dysreflexia?
    http://www.spinalsoothers.com/medicalemer.html
    Get Visible Life after Spinal Injury " HOPE" News Bulletin Counseling Outdoors Medical Help ... Life After Spinal Injury Medical Emergencies What are medical emergencies? Medical Emergencies are a few conditions affecting spinal cord injured people that require urgent treatment. They can happen anytime irrespective of the numbers of years that have passed after your injury. You should be aware of them and the first aid that is required just incase you are faced with them at home They are as follows:
  • Autonomic Dysreflexia Pressure sore Bladder blockage or infection Kidney infection Chest infection Sudden lowering of Blood Pressure
  • What Is Autonomic Dysreflxia? This is a warning system to let you know that something is wrong; and that your body is experiencing pain or discomfort. This is an acute emergency and if not treated quickly may lead to bleeding in the brain with serious consequences. It consists of a rapid increase in blood pressure caused by pain, irritation or over-stimulation in a paralyzed part of the body. Only if you have a spinal cord lesion above T6 are you prone to autonomic dysreflexia or hyper-reflexia. Your family members should also be aware of Autonomic Dysreflexia so that they can help you when needed. How will I know that I have autonomic dysreflexia?

    59. Multicept A/S Recommended Reading
    autonomic dysreflexia. autonomic dysreflexia may be caused by various factorssuch as for instance an overdistended bowel or urinary bladder.
    http://www.multicept.com/Uk/fertfaq.htm
    FAQ
    Frequently Asked Questions

    Given that penile vibratory stimulation is new, people are naturally curious to learn more about it. Here is a list of answers to the most frequently asked questions.
    Your Involvement
    If you have comments, questions or recommendations concerning material you would like to see published on our internet site, or if you are interested in sharing your experiences or views, please send us an E-mail: info@multicept.com
    Infertility
    What are the main causes of infertility in men following spinal cord injuries?
    The major causes of infertility are ejaculatory dysfunction and poor semen quality
    Ejaculatory dysfunction
    Is it possible to re-establish the ejaculatory function?
    Less than 10% of all spinal cord injured men are able to obtain ejaculation during sexual intercourse or by masturbation. With penile vibratory stimulation it is possible to induce ejaculation in the major part of spinal cord injured men What kind of vibratory equipment should be used? In order to obtain the desired result (ejaculation) a vibratory device with adequate frequency and amplitude outputs, as determined during clinical studies and reported in medical journals, is required. FERTI CARE®personal is the only medical grade vibrator available developed specifically with an output power required to induce ejaculation in spinal cord injured men.

    60. SCI Fact Sheet, What Is Dysreflexia
    WHAT IS DYSREFLEXIA? autonomic dysreflexia (AD), also known as Hyperreflexia,is a potentially dangerous complication of spinal cord injury (SCI).
    http://www.spinalcordinjury.net/docs/scifact5.html
    Spinal Cord Injury Network
    WHAT IS DYSREFLEXIA?
    Autonomic Dysreflexia (AD), also known as Hyperreflexia, is a potentially dangerous complication of spinal cord injury (SCI). In AD, an individual's blood pressure may rise to dangerous levels and if not treated can lead to stroke and possibly death. Individuals with SCI at the T-6 level or above are at greater risk. AD usually occurs because of a noxious (irritating) stimulus below the level of the injury. Symptoms include headache, facial flush, perspiration, and a stuffy nose.
    AD occurs primarily because of an imbalance in the body systems which control the blood pressure. The human body is an incredibly complicated and beautifully balanced machine. There are balances to each system of the body, including the blood pressure. One of the major ways the body controls blood pressure is by tightening or relaxing little muscles around the blood vessels. When the muscles contract, the blood vessels get smaller and blood pressure increases. Imagine a garden hose with water streaming through it; when you put your thumb over the opening of the hose, reducing the opening for the water to flow through, the water shoots out at a higher pressure. Similarly, when the blood vessels are smaller, the blood rushes around your body at higher pressure.
    When a noxious stimulus occurs, a reflex is initiated that causes the blood vessels to constrict and raises the blood pressure. In an intact spinal cord, this same stimulus also sets in motion another set of reflexes that moderates the constriction of blood vessels. However, in someone who has SCI at the T-6 level or above, the signal which tells the blood vessels to relax cannot get through the spinal cord because of the injury. Some of the nerves at the T-6 level also control the blood flow to and from the gut, which is a large reservoir of blood. Uncontrolled activity of these nerves may cause the blood from the gut to flow into the rest of the blood system. The result is that blood pressure can increase to dangerous levels and the increase in blood pressure must be controlled by outside means.

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