<unk>  is a massive sympathetic discharge that can occur in association with spinal cord injury or disease (e.g. multiple sclerosis). It is triggered by a variety of noxious stimuli, including bladder distension, irritation to the urinary tract, skin ulcers, fractures, abdominal emergencies, bowel impaction and uterine contractions. Sometimes the triggering factor is obscure.
The risk is greatest with cervical spinal cord lesions and is rare with lesions below T6. It has rarely been reported in spinal cord lesions as low as T10. The first episode may occur weeks to years after spinal cord injury takes place, but most people at risk (80%) develop their first episode within the first year after injury. The diagnosis is usually not subtle, although asymptomatic events have been documented. This condition is distinct and usually episodic, with the patient experiencing remarkably high blood pressure (often with systolic readings over 200 mm.Hg), intense headaches, profuse sweating, facial erythema, goosebumps, nasal stuffiness, and a "feeling of doom". An elevation of 40 mm. Hg. over baseline systolic should be suspicious for dysreflexia.
Older patients with very incomplete spinal cord injuries and systolic hypertension without symptoms are usually experiencing essential hypertension, not<unk> . Aggressive treatment of these elderly patients with rapidly acting antihypertensive medications can have disastrous results.<unk>  differs from<unk>  instability, a term used to describe the variety of modest cardiac and neurological changes that accompany a spinal cord injury, including bradycardia, orthostatic hypotension, and ambient temperature intolerance.
Autonomic dysreflexia
Spinal autonomic dysreflexia
Neuroglycopenia
Neuromyotonia
Hyperreflexia
Myotonia
Hyporeflexia
Paraesthesia