Autonomic dysreflexia—what best describes its symptom pattern?

Autonomic dysreflexia—what best describes its symptom pattern?

• A. Paralysis below injury
• B. Loss of sensation in all limbs
• C. Rapid breathing with wheezing
• D. Sympathetic discharge due to noxious stimuli after spinal shock has resolved

Answer: (D)

Autonomic dysreflexia is an exaggerated sympathetic response to a noxious stimulus below the level of a high spinal cord injury, occurring after spinal shock has resolved. Because the injury blocks brain down-regulation, a triggering event such as bladder distension or bowel impaction below the injury sends a strong afferent signal that elicits a massive, unopposed sympathetic discharge. The result is a sudden, dangerous rise in blood pressure with signs like headache and sweating above the level of injury, pallor or coolness below the level of injury, and sometimes bradycardia from baroreceptor reflexes. This pattern—a sympathetic surge initiated by a noxious stimulus after spinal shock—best describes autonomic dysreflexia. The other options describe deficits that are not characteristic of this autonomic storm.

Autonomic dysreflexia is an exaggerated sympathetic response to a noxious stimulus below the level of a high spinal cord injury, occurring after spinal shock has resolved. Because the injury blocks brain down-regulation, a triggering event such as bladder distension or bowel impaction below the injury sends a strong afferent signal that elicits a massive, unopposed sympathetic discharge. The result is a sudden, dangerous rise in blood pressure with signs like headache and sweating above the level of injury, pallor or coolness below the level of injury, and sometimes bradycardia from baroreceptor reflexes. This pattern—a sympathetic surge initiated by a noxious stimulus after spinal shock—best describes autonomic dysreflexia. The other options describe deficits that are not characteristic of this autonomic storm.