Autonomic Dysreflexia

Autonomic dysreflexia is a life-threatening syndrome occurring in patients with spinal cord injury above T6, characterized by sudden, exaggerated sympathetic discharge in response to noxious stimuli. Clinically, patients present with severe hypertension, headache, flushing, sweating, and bradycardia. Pathophysiology involves unmodulated sympathetic reflexes below the lesion due to disrupted descending inhibitory input. Diagnosis is clinical, with rapid blood pressure monitoring essential. Management includes immediate removal of triggers, pharmacologic blood pressure control, and long-term preventive strategies; prognosis improves with prompt recognition, although repeated episodes can lead to cerebrovascular complications.