Autonomic Dysreflexia – Key points



  • Autonomic dysreflexia (AD) is a rapid rise in blood pressure in response to something harmful or painful below the level of the spinal cord injury.
  • It only occurs in people with spinal cord injuries T6 and above.
  • If left untreated the blood pressure can rise to dangerous levels, risking stroke, cardiac arrhythmias, seizures, even death.
  • Typically there is a pounding headache as the blood pressure rises.  Other symptoms can include flushing above the level of the lesion, slow heart rate, sweating, goose bumps, nausea, nasal congestion, blurred vision, shortness of breath and anxiety.
  • Some or all of the symptoms may be present.
  • AD can be triggered by anything painful or irritating below the level of the lesion.  The most common causes are bladder related, followed by bowel problems.
  • Relieving the cause of the AD will resolve the AD episode.
  • If the cause cannot be found or treated medication is required to lower the blood pressure.
  • All people with spinal cord lesions at T6 and above should carry their Autonomic Dysreflexia Medical Emergency Card at all times.
  • AD is best prevented by avoidance of factors which trigger AD.
  • People at risk of AD often carry an ‘AD Kit’ with them – items useful to resolve AD such as catheters and prescribed medication.

What is Autonomic Dysreflexia