Autonomic Dysfunction In Spinal Cord Disorder:Clinical Features And Pathophysiology

Autonomic dysreflexia(AD)is an acute syndrome of excessive,uncontrolled sympathetic discharge with potentially serious consequences that can occur in individuals with spinal cord injury(SCI)above T6 level.The clinical presentation of AD often includes a pounding headache,nausea,malaise,nasal obstruction,and anxiety.Dysreflexia is not always severe and may include only sweating,flushed skin above the segment of injury and small increases in AP,but this condition can become uncontrolled,leading to life-threatening hypertension.So there is an urgent need for the early recognition and proper management of episodes of autonomic dysreflexia.Fully understanding the pathophysiology of the autonomic nervous system following SCI may also of great importance.We collect three cases of potentially life-threating outcomes associated with autonomic dysreflexia,which manifest increased AP above normal.Based on our knowledge and recent papers,effective therapeutic interventions can be given to minimize undesired abnormalities and improve the quality of daily living.Purposes and MethodsWith the retrospective analysis of three case related to episodes of autonomic dysreflexia,we want to increase the awareness of the clinical features of autonomic dysreflexia among clinicians.Although autonomic dysreflexia is known to occur in patients with traumatic spinal cord injury,there is a growing body of evidence in the literature that nontraumatic SCI can also cause dysreflexia.With the knowledge of the neural basis,we are also try to understand the pathophysiology of the autonomic nervous system following SCI.Results1.There is still lots to do to improve the aware of the clinical features of AD,and it can also happen in nontraumatic spinal cord injury.These disabilities can evoke potentially life-threatening symptoms that severely interfere with the daily living of those with SCI.2.Prevention of the autonomic dysreflexia plays a great role in the treatment of SCI patients.The patients should be taught to avoid it.3.The neural mechanisms and pathophysiology underlying autonomic dysfuntions after SCI is partially elucidated.Understanding the mechanisms for autonomic dysreflexia will provide us with strategies for treatment,if given early,can prevent those serious disorder from developing.