AUTONOMIC DYSREFLEXIA

Autonomic dysreflexia (sometimes called hyperreflexia) is unique to people with spinal cord injury above the T6 level and is a condition you should be aware of. It occurs when there is some stimulation below the level of your injury (see list below) that causes part of your nervous system to respond in an uncontrolled way.

You will recognize autonomic dysreflexia by these symptoms..

• high blood pressure
• pounding headache
• blurred vision
• profuse sweating
• facial flushing
• nasal congestion or stuffiness

Autonomic dysreflexia can be brought on by specific stimulation in areas below the level of injury. These may include:

• bladder infection
• bladder or kidney stones
• being constipated or having a full bowel
• pressure sores
• burns
• ingrown toenails
• labour and delivery, vibro-stimulation of the genitals
• intense sexual activity

When autonomic dysreflexia occurs during sexual activity that activity should be stopped for a few minutes. Alternatively, another activity may be substituted. It is important that you try to find creative solutions instead of stopping all forms of sexual activity. If autonomic dysreflexia continues to be a problem or is interfering with your sexual life you may want to talk to your doctor about using a medication that you take just before sexual activity to prevent the dysreflexia from happening.

During labour and delivery, contractions of the uterus can cause autonomic dysreflexia which can be mistaken for a condition called pre-eclampsia which some able-bodied women experience with pregnancy. The two are very different and are managed differently. With pre-eclampsia, the high blood pressure is continuous. With autonomic dysreflexia, the blood pressure and other symptoms are only present during the contractions. In between the contractions the blood pressure will go down. Your doctor will be aware of the need to carefully monitor your blood pressure when you are in labour. [See also Pregnancy, Labour and Delivery: link to consumer section on Preg,labour and delivery]

Many men with spinal cord injury do not ejaculate. One of the methods used to obtain sperm that can then be used for insemination is vibro-stimulation. When vibro-stimulation is used to collect ejaculate it can bring on autonomic dysreflexia. It is recommended that at least initially the procedure be conducted under medical supervision and with constant blood pressure monitoring.