Autonomic Dysreflexia: An Emergency Situation

What you should know about autonomic dysreflexia

Almost anyone who has a spinal-cord injury (SCI) above T6 can have a complication called autonomic dysreflexia (AD) — the body’s abnormal response to pain or discomfort. It’s important to be able to recognize AD, know what causes it, and learn how to treat it because it can be life threatening. Symptoms can include the following:


o Severe pounding headache

o Seeing spots in front of your eyes

o Blurred vision

o Slow heart rate

o Goosebumps above level of SCI

o Sweating above level of SCI

o Flushing of skin above level of SCI

o Nasal stuffiness

o Anxiety or jitters

o Tight chest

o Trouble breathing


High blood pressure causes headache, spots, and blurred vision. The slow heart rate is due to the brain’s response to high blood pressure. And the other symptoms listed above result from the body’s exaggerated response to continuous dilation of blood vessels. Uncontrolled high blood pressure is the dangerous part of AD, because if it is high enough it can cause a stroke or even death.


Common causes are:


o A full or distended bladder

o Severe constipation

o Infections

o Tests and procedures

o Pressure ulcers

o Traumatic pain (e.g., severe cuts or broken bones)

o Hot and cold temperatures

o Sunburn

o Tight clothing

o Pressure on the testicles or penis

o Severe menstrual cramps or labor

o Stomach ulcers

o Some drugs

o Ejaculation


What To Do

(1) Sit up if you are lying down, to decrease your blood pressure.

(2) Find and remove the cause: Check for bladder, bowel, and skin problems.

(3) Get help immediately if you cannot find the cause. Call or go to the nearest hospital.

(4) Carry information that explains AD. It may save your life, because not all health providers know how to treat it.



The most common causes of AD are a full or distended bladder, and bowel impactions. Make sure your bladder is emptied routinely, your catheter is draining well, and you have routine bowel movements.

If you have AD more often than others do, your doctor may prescribe medication to prevent it.

Remember, if you develop AD, you will soon learn what causes it for YOU.


To download a free copy of the consumer guide Autonomic Dysreflexia: What you should know, visit and go to “publications.” This resource was developed by the Consortium for Spinal Cord Medicine with financial and administrative support from the Paralyzed Veterans of America.


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