Autonomic Dysreflexia


Autonomic_dysreflexia6aWhat to do if AD is suspected:

  • You should sit up if possible, or raise your head to 90 degrees – if you can lower your legs, do so.
  • Next, loosen or remove anything tight
  • Check blood pressure every five minutes. Unusually high blood pressure readings may be a sign of autonomic dysreflexia, eg:
    • 20 mm to 40mm Hg above baseline in adults 
    • 15mm above baseline in children
    • 15mm to 20mm above baseline in adolescents
  • Most importantly, you or your carer should locate the cause of the AD:
    • Begin by looking for your most common causes: bladder, bowel, tight clothing, skin issues
  • Once identified, the cause needs to be treated or removed. Keep in mind that AD may get worse before it gets better.
  • Seek prompt medical advice if the cause cannot be identified or the hypertension cannot be controlled.
  • If the hypertension is severe, or the cause still cannot be identified, you will need to be treated with medication.

Medications are generally used only if the offending trigger/stimulus cannot be identified and removed – or when an episode persists even after removal of the suspected cause.

Potentially useful medications include:

Nifedipine 10mg – the content of the capsule should be put under the tongue and the capsule swallowed.

Autonomic_dysreflexia7aNote: Individuals at risk of experiencing Autonomic dysreflexia should be prescribed a small quantity of Nifedipine to be kept close at hand.

Glycerol trinitrate transdermal patches (0.2mg/hour) – These will be removed once the episode has been resolved to reduce hypotension.
Autonomic_dysreflexia7bGlycerol trinitrate spray 400mcg – one to two sprays under the tongue.

Note: If Viagra or Cialis is being taken GTN must not be used as B/P will be lowered too much.

It is recommended that you should carry an emergency medical alert card with a short summary of causes and treatment which may assist medical practitioners in a community setting.