Abstract
Introduction: During the stage of spinal shock the conventional view is that autonomic activity is abolished. Here, evidence is presented that autonomic activity is still present.
Patients: Four patients with acute cord transactions are presented: one new case and three from the literature.
Definitions: The definitions of spinal shock and autonomic dysreflexia are given.
Methods: All four cases showed acute autonomic dysreflexia between 7 and 31 days after acute cord transection at a stage when the tendon reflexes were abolished.
Results: Two cases showed a severe rise in blood pressure; the two earlier cases, before blood pressure was routinely recorded, profuse sweating. In two cases autonomic dysreflexia was obtained when the bladder was overdistended with 1000 ml and 1600 ml. In the other two cases it occurred in response to traumatic catheterisation. This was found when supramaximal stimuli were applied. It has not been recorded routinely as, with modern management, the bladder does not get overdistended or traumatised.
Discussion: Other evidence, the blood pressure, and urethral tone is presented to show that sympathetic reflex activity of the cord is not abolished during spinal shock.
Clinical significance: The clinical importance of this is that autonomic dysreflexia can be seen at an early stage and it should be considered in the differential diagnosis of a sick patient immediately after spinal injury.
Spinal Cord (2000) 38, 229–233.
Similar content being viewed by others
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Silver, J. Early autonomic dysreflexia. Spinal Cord 38, 229–233 (2000). https://doi.org/10.1038/sj.sc.3100996
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.sc.3100996
Keywords
This article is cited by
-
Anästhesiologisches Vorgehen bei Patienten mit spinalem Querschnitt
Der Anaesthesist (2016)
-
Incidence of symptomatic autonomic dysreflexia varies according to the bowel and bladder management techniques in patients with spinal cord injury
Spinal Cord (2011)
-
Assessing the capacity of the sympathetic nervous system to respond to a cardiovascular challenge in human spinal cord injury
Spinal Cord (2008)
-
Calcitonin gene-related peptide immunoreactivity in chronic human spinal cord injury
Spinal Cord (2007)