Autonomic Dysreflexia: What is it and why should I know the symptoms?


Frequently I will see a question asking “What is Autonomic Dysreflexia?” and I will cringe because AD could quickly become life-threatening if untreated. Allow me to explain.

Autonomic Dysreflexia or AD as you will hear it refers to a sudden or prolonged response to an irritant that affects the body below the level of the spinal cord injury.  Think about that….below the level of injury, which means the irritant is NOT felt due to paralysis.  AD occurs in a Spinal Cord Injury (SCI) individual who is a T6 or above injury.  Meaning if your loved one is a paraplegic of thoracic level 6 or above and that includes all quadriplegics, going up towards the head, he/she is prone to experience AD. It CAN be and WILL be a medical emergency if the culprit creating the irritation is not located and corrected.  Usually, once the culprit of the irritation is corrected the AD reverses.  Immediate relief is felt and BP suddenly decreases.  During this event of AD, the BP will increase to dangerous levels if the offender or what is causing the irritation is not located and corrected quickly.  That’s why it’s best to have a BP machine of some sort in the home for use and to know your blood pressure normals. So, if you start to experience AD and your BP begins to creep up, start to take action to find what is causing the symptoms.

What Are the Common Signs?

  • A sudden severe rise in blood pressure
  • Pounding headache
  • A change in heart rate
  • Flushed skin or shivering above the level of injury
  • Anxious feeling
  • Sweating above or below the level of injury
  • Blurred vision
  • Stuffy nose
  • Pale skin or goose bumps below the level of injury

What to do if you start to experience AD: The only agenda at this point is to quickly locate the culprit causing the problems.

  • Sit up and raise your head
  • Empty your bladder
  • Remove tight clothing, leg bag straps, and shoes. Undress from your feet up and check your skin for anything that could irritate or cause pain
  • If you have a catheter, look for kinks or a full drainage bag
  • Change the catheter
  • If you do not have a catheter, gently catheterize yourself
  • Check the rectum for stool

Hence, when AD symptoms persist get medical help quickly by calling 911.

AUTONOMIC DYSREFLEXIA is a condition everyone needs to be familiar with.  It can certainly lead to stroke, seizures, or even death. Know what AD is and what to do if you begin to experience it. Correcting the culprit is of utmost importance.

Patty Kunze, BSN, RN