Autonomic dysreflexia

Intrathecal - Early symptoms of baclofen withdrawal may include return of baseline spasticity, pruritus, hypotension, and paresthesias. Some clinical characteristics of the advanced intrathecal baclofen withdrawal syndrome may resemble autonomic dysreflexia, infection (sepsis), malignant hyperthermia, neuroleptic-malignant syndrome, or other conditions associated with a hypermetabolic state or widespread rhabdomyolysis. 

Psychotic disorders Cautiously treat patients suffering from psychotic disorders, schizophrenia, or confusional states and keep under careful surveillance because exacerbations of these conditions have been observed with oral administration. Autonomic dysreflexia Use with caution in patients with a history of autonomic dysreflexia. The presence of nociceptive stimuli or abrupt withdrawal may cause an autonomic dysreflexic episode. 

The most important adverse effect of capsaicin is the initial burning sensation that it produces. Intravesical capsaicin induces intense suprapubic pain during intravesical instillation that may be made tolerable by lidocaine in some but not all patients. Capsaicin also frequently causes a transient worsening of the urinary conditions before improvement of symptoms due to desensitization of bladder afferents becoming evident. In patients with high spinal cord lesions capsaicin might provoke life-threatening autonomic dysreflexia. 

After the dialogue begins, ask more specific questions. For example, if the person has a spinal cord injury and needs regular, intermittent catheterization to prevent potentially life-threatening complications (e.g., autonomic dysreflexia), the person should be encouraged to think about what equipment he or she should take if evacuation is necessary and who will provide assistance if needed. 

Autonomic dysreflexia (facial flushing, sweating, nasal congestion, headache and paroxysmal hypertension) can occur in quadriplegic patients in response to bladder distention during cystography (SEDA-19, 430). 

Wineinger MA, Basford JR. Autonomic dysreflexia due to medication misadventure in the use of an isometheptene combination to treat migraine. Arch Phys Med Rehabil 1985 66(9) 645-6. 

The effect of the gadolinium in this case supports the assumption that volume expansion of the epidural space was the more likely culprit than an action of the local anesthetic itself. The authors speculated that the injection may have compressed venous and arterial structures supplying the spinal cord, which might have caused autonomic dysreflexia, resulting in massive secretion of adrenaline and hypertensive crises. Hypertensive encephalopathy, which typically... 

A patient with a T5 spinal cord transection, with a long-standing history of autonomic dysreflexia, developed hypotension during surgery after being turned from a supine... 

Archer TL. Pulse contour analysis aids the understanding of autonomic dysreflexia hemodynamic findings in a T5 paraplegic surgical patient treated for hypotension with phenylephrine and ephedrine. J Clin Anesth 2009 21 378-81. 

Autonomic dysreflexia is a life-threatening condition characterized by severe hypertension, anxiety, sweating, piloerection, headaches, and bradycardia. Immediate treatment is mandatory. 

Kalincik, T, Choi, EA, F on, F, Bianco, J, Sutharsan, R, Hayward, I, Mackay-Sim, A, Carrive, P, and Waite, PM. 2010. Olfactory ensheathing cells reduce duration of autonomic dysreflexia in rats with high spinal cord injury. Autonom Neurosci 154(l-2) 20-29. 

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