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Autonomic Dysreflexia

Medically reviewed by Last updated on Jan 5, 2023.

What is autonomic dysreflexia?

Autonomic dysreflexia (AD) is a condition that causes sudden, extremely high blood pressure. AD is most common in people with a spinal cord injury in the neck or upper back.

What causes AD?

Ask your healthcare provider about these and other causes of AD:

  • Overfull bladder or urinary tract infection
  • Overfull bowel, constipation, or other bowel problems, such as an ulcer or gall stones
  • Pressure injuries or ingrown nails
  • Sexual activity
  • Broken bones or bone spurs
  • Tight clothes

What are the signs and symptoms of AD?

  • Severe, pounding headache
  • Red, sweaty, or blotchy skin above the level of your injury
  • Stuffy nose or nausea
  • Slow heartbeat
  • Cool, clammy skin with goose bumps below the level of your injury
  • Nervousness or anxiety
  • Tightness in chest

How is AD diagnosed?

Your healthcare provider will ask about your signs and symptoms. You may need any of the following:

  • Blood and urine tests may show what is causing your signs and symptoms.
  • A cystometrogram measures the way your bladder squeezes when it fills and empties. Healthcare providers watch your blood pressure while your bladder is filling.
  • A CT scan or MRI may show the cause of your signs and symptoms. You may be given contrast dye to help your organs show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

How can I manage my AD?

Act as soon as you have signs and symptoms. You may need to do any of the following:

  • Sit up or lie with your head raised to decrease your blood pressure. Check your blood pressure every 5 minutes.
  • Loosen any tight clothes , belts, bandages, or braces.
  • Empty your bladder catheter and make sure the tubing is not kinked or blocked.
  • Try to have a bowel movement.
  • Check your skin for red areas. Change your position at least every 2 hours.
  • Take blood pressure medicine to help decrease your blood pressure.

How can I help prevent AD?

Healthcare providers will teach you a bladder and bowel movement program. This program includes ways to help you urinate and have bowel movements regularly. This will help prevent urine buildup, constipation, and AD. Ask for more information on bladder and bowel training.

When should I contact my healthcare provider?

  • Your blood pressure is higher than what your healthcare provider said it should be.
  • You have a fever.
  • You have a red area or sore on your skin.
  • You have blood in your bowel movement.
  • Your urine is cloudy, smells bad, or has blood in it.
  • You urinate less than usual.
  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You have trouble breathing.
  • You have a severe headache.
  • You are too dizzy to stand or have trouble walking or moving.
  • You are not urinating at all.
  • You have severe abdominal pain and have not had a bowel movement in a while.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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