Date posted: 18th October 2016

Autonomic Dysreflexia is a potentially dangerous condition that can occur after a spinal cord injury. Due to its severity, it is important for all care givers to understand the condition. In this article, CPIMS discusses Autonomic Dysreflexia management, symptoms and treatment.

What does autonomic dysreflexia mean?

Autonomic Dysreflexia, also referred to as Hyperreflexia, is defined as the over activity of the autonomic nervous system (ANS). This over activity causes a sharp incline in blood pressure and usually occurs suddenly. Autonomic Dysreflexia in spinal cord injury is considered to be a medical emergency and, if the correct treatment isn’t sought, has the potential to cause further injury, including seizures and strokes. In some cases, the condition can be life-threatening.

What causes autonomic dysreflexia?

Autonomic Dysreflexia in spinal cord injury can be caused by an irritating stimulus below the level of injury, including an overfull bladder. To others, this may lead to an uncomfortable feeling, however after injury it can cause Autonomic Dysreflexia. Those with injuries at level T-5 or above are most at risk of Autonomic Dysreflexia, as the stimulus cannot send nerve impulses to the brain, due to being blocked by the lesion at injury level. A reflex is activated, causing overactivity from the autonomic nervous system, resulting in spasms and a narrowing of the blood vessels. In turn, this causes a rise in blood pressure, causing Autonomic Dysreflexia.

Signs and symptoms of Autonomic Dysreflexia

Autonomic Dysreflexia symptoms can vary depending on the individual. However, there are some common signs and symptoms of the condition. As Autonomic Dysreflexia can occur suddenly, symptoms may be slight, however the most common symptoms can include:

  • Headache
  • Sweating
  • Blotchiness of the skin
  • Flushed face
  • Nausea
  • Clammy skin
  • Slow pulse

It is vital that any care giver who recognises these symptoms in patients who have a spinal injury seeks help as soon as possible.

autonomic dysreflexia management

Autonomic Dysreflexia treatment

In order to minimise the damaging effects of Autonomic Dysreflexia, it is important to seek treatment immediately. The end goal of Autonomic Dysreflexia treatment is to reduce high blood pressure by eliminating the irritant. In some cases, Autonomic Dysreflexia can be treated quite simply, by removing tight clothing; checking and draining a catheter; removing potential triggers, such as a cold draft or object which may be increasing pressure; or sitting in a position which will allow the blood to flow to the feet.

In more severe cases, drugs such as vasodilators may have to be administered in order to bring blood pressure down and under control. It is important that any care giver, occupational or physical therapist know how to treat Autonomic Dysreflexia, in case Hyperreflexia occurs during a therapy session.

Managing autonomic dysreflexia

Through correct Autonomic Dysreflexia management, it is possible to reduce the chances of the Hyperreflexia. There are some simple ways of moderating the recurrence of the condition, including:

  • Frequent pressure relief
  • Maintenance of a regular bowel programme
  • Well balanced diet
  • Avoiding sun burn or scalding
  • Correct medication
  • Correct use of catheter
  • Skin assessments

In order to recognise Autonomic Dysreflexia symptoms, treatment and maintenance, it is important that those at risk – and the people close to them – understand preventative measures and the signs and symptoms of the condition.

CPIMS are experienced case managers, specialised in helping those with spinal and brain injuries. We assist with the rehabilitation and immediate needs of the patient, as well as helping family members. If you require assistance, or further information, please contact us on 0844 3710616 or email

For more information about Autonomic Dysreflexia, you can read our PDF document.

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