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This is a paroxysmal syndrome of hypertension, hypohydrosis (above level of injury), bradycardia , flushing and headache in response to noxious visceral and other stimului. It is most commonly triggered by bladder distension or rectal loading from fecal impaction. Autonomic dysreflexia develops in individuals with a neurologic level of spinal cord injury at or above the sixth thoracic vertebral level (T6). Autonomic dysreflexia causes an imbalanced reflex sympathetic discharge, leading to potentially life-threatening hypertension. T6 is of particular importance in the pathogenesis of autonomic dysreflexia. The splanchnic vascular bed is one of the body’s largest reserves of circulatory volume and is controlled primarily by the greater splanchnic nerve. This important nerve derives its innervation from T5-T9. Lesions to the spinal cord at or above T6 allow the strong and uninhibited sympathetic tone to constrict the splanchnic vascular bed, causing systemic hypertension. Lesions below T6 generally allow enough descending inhibitory parasympathetic control to modulate the splanchnic tone and prevent hypertension. Treatment:- avoid urinary and fecal retention. Control BP:- Alpha1 blocker Calcium channel blocker (nifedipine) #hypertension #neurology #neuroscience #nephrology #medicine #usmle #usmlestep1 #doctor #doctordconline #nhs #nurse #nursing #hospital #patient #amc #plab @doctordconline
