Find the cause of AD and fix the problem if you can. Sit upright. Loosen any tight clothing or anything else that might be tight fitting. Check to see if bladder is too full.
Is your catheter tube kinked or a condom catheter on too tight? Does your bladder need emptying? Check to see if your bowel is full. If you have lidocaine gel, you can use it to numb the anal area before you check your bowel. This can help prevent causing more discomfort as you are checking. Check skin for a pressure sore, inflamed hemorrhoids, cuts, burns, ingrown toenails, or any other skin irritation. Check for broken bones.
Call Clip the card at the end of the factsheet to carry with you. Is there treatment for AD? Good ongoing personal care is the best way to prevent AD. Maintain a consistent bladder program and take necessary steps to prevent infections.
Maintain a consistent bowel program. Check your skin daily for pressure ulcers, and do regular pressure reliefs also called weight shifting, pressure redistribution and pressure reduction to prevent pressure ulcers. Avoid other skin injuries such as cuts, bruises and sunburn. Make sure you wear loose clothing and avoid clothes and shoes that are too tight. Use good techniques and well-functioning equipment to minimize the risk of falls and injuries.
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It can come about as a symptom of a number of conditions. Most underlying causes…. Health Conditions Discover Plan Connect. Medically reviewed by Deborah Weatherspoon, Ph. How autonomic dysreflexia happens in the body. What is the long-term outlook? Read this next. Spinal Cord Injury. Medically reviewed by William Morrison, M. Medically reviewed by Nancy Hammond, M. The detection of AD has been classically noted to be due to a trigger that stimulates the body into an AD episode.
A trigger is something that the body perceives as noxious or irritating below the level of injury. If the message that something small or big is bothering the body where sensation is decreased, the sensory nerves cannot effectively or efficiently send a message to the brain to correct the situation. As a result, the ANS would typically send a message to the motor nerves to move the body which would correct the situation.
However, due to nerve miscommunication, a total blast of messages is sent. The messages are unable to get through which results in this massive burst of nerve activity in the body, usually above the level of injury.
With the discovery of silent AD, triggers may not be noted or act as a stimulus for an AD episode. In silent AD, blood pressure is affected without the identification of a trigger.
An AD episode may occur without symptoms which is why it is called silent AD. Triggers include a variety of noxious sources or irritations to the body. Common triggers are listed below. Individuals have different triggers. The most common noxious irritations that stimulate episodes of AD are from the bladder, bowel, and skin.
However, the list of possible triggers is always increasing. Triggers fit into categories, although your trigger may be quite unique. As more triggers for AD are being identified, it seems anything bothersome can be an issue. These are some additional triggers:. AD is a medical emergency. When blood pressure is raised, you need to act immediately.
Do not hesitate to call if needed. Your blood pressure should begin to lower and correct itself. Continue to monitor your blood pressure for at least two hours. If the trigger or multiple triggers are found and removed or corrected but blood pressure remains elevated, call Medical attention is needed immediately to prevent a cardiovascular event such as stroke, cardiac arrest, seizures, retinal hemorrhage, pulmonary edema, and death.
If you have identified specific triggers for AD, other medications and treatments can be used to help control those known causes. Alterations in diet for stool consistency, use of a gentle approach to suppository and digital stimulation, or local anesthetic for bowel programs will help if bowel issues are AD triggers. To aid in reduction of skin triggers, medication can be used to control tone spasms , ensure you are not sitting on a wrinkle or other skin irritant, perform pressure releases and check your skin for pressure injury, as well as use of pressure dispersing equipment, and monitor your leg bag if you use one to ensure it is not pulling on your leg as it fills with urine, check your shoes to be sure they fit and maintain foot hygiene avoiding cracked callouses and ingrown toenails.
Be cautious with your body when moving to avoid injury. Protect your eyes from computer overuse and bright sunshine. A video explaining the cause and treatments for Autonomic Dysreflexia from the Reeve Foundation can be viewed here. This card can be shared with healthcare professionals, caregivers, teachers, and others.
The wallet card is an easy to carry trifold card that can be placed in your wallet for quick access. It is available for adults and children as well as in a variety of languages.
You will need to be involved with identification of AD episodes. The moment you start to feel an episode of AD is occurring, begin treatment by sitting up. Call for assistance to be sure you do not fall, harm yourself, or lose consciousness. Someone should call if the trigger cannot be identified or if treatment resolutions are not working. A physiatrist, neurologist, primary care physician, medical doctor, or nurse practitioner that can diagnose AD will provide treatments that are appropriate for your AD episodes.
If the episodes are easily corrected, monitoring with careful consideration of avoiding identified triggers may be necessary. In more severe cases, medications to treat AD will be prescribed. Also, if your trigger is known, medication can be prescribed to reduce the trigger thereby reducing or eliminating AD episodes.
A Rehabilitation Registered Nurse is a care provider in the hospital, rehabilitation hospital or community that can educate you about AD, help you learn to identify it, and how to treat it. They will help you learn to deal with emergency situations. A Urologist may provide treatment such as bladder numbing agents and treatments to avoid triggering AD. Care providers at home can assist with monitoring you for AD episodes as well as providing emergency care. They are typically the person to call , as necessary.
If you have AD, you need to let all your healthcare providers and caregivers know about your condition in case it arises, and you do not have time to call for help. This includes therapists who will provide therapy using strategies to avoid an AD episode and all caregivers who can ensure your safety. Traditionally, research about causes and treatments for autonomic dysreflexia has focused on the individual trigger such as tone spasms , pressure, bladder, and bowel issues.
However, healthcare professionals note those individuals who are treated for tone or neuropathic pain have less incidence of AD. This has sparked an interest in examining the autonomic nervous system as a whole for treatments rather than just one subset of causes Rabchevsky, et al.
A study of autonomic nervous system tests was completed to see if predictors for AD could be isolated. Deep breathing, Valsalva maneuver and tilt table test challenged individuals with spinal cord injury.
Measurements of baroreflex sensitivity BRS , and spectral analysis of heart rate and blood pressure variability were assessed along with blood level of catecholamines and vasopressin levels and clinical and radiological examinations. AD was demonstrated by Although this study is not practical in clinical use at this time, it is an effective assessment of those who have AD perhaps identifying those without symptoms.
Previously, AD was thought to be only in individuals with the manifestation of symptoms. Recently scientists discovered AD in individuals who did not have any symptoms. This is exhibited by elevated blood pressure but no changes in body comfort. Silent AD is now a critical issue for individuals who are at risk of serious complications but have no warning Kirshblum, et al. This helps determine which tests you need. Other conditions share many symptoms with AD, but have a different cause.
So the exam and testing help the provider rule out these other conditions, including:. Proper treatment depends on the cause. If medicines or illegal drugs are causing the symptoms, those drugs must be stopped. Any illness needs to be treated. For example, the provider will check for a blocked urinary catheter and signs of constipation. If a slowing of the heart rate is causing AD, drugs called anticholinergics such as atropine may be used. Very high blood pressure needs to be treated quickly but carefully, because the blood pressure can drop suddenly.
People with AD due to a medicine usually recover when that medicine is stopped. When AD is caused by other factors, recovery depends on how well the disease can be treated. Complications may occur due to side effects of medicines used to treat the condition. Long-term, severe high blood pressure may cause seizures, bleeding in the eyes, stroke, or death.
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