Autonomic dysreflexia in spinal cord injury

### What you need to know Autonomic dysreflexia is a potentially life threatening complication of spinal cord injury. It carries a mortality rate of 22%1 and increases the risk of stroke by 300% to 400%.2 Clinicians working in emergency or urgent care may not see patients with this condition often, but when they do, prompt recognition and treatment are required. This practice pointer gives a brief overview of autonomic dysreflexia and how to identify it. Autonomic dysreflexia is the product of dysregulation of the autonomic system, leading to an uncoordinated response to a noxious stimulus below the level of a spinal cord injury,2 usually in individuals with a spinal cord injury above the level of T6 (fig 1). It is three times more prevalent in those with complete spinal cord injury than in those with incomplete injury (91% versus 27%, respectively).3 Autonomic dysreflexia is clinically defined as an acute episode of systolic blood pressure elevated 25 mm Hg or above the patient’s normal measurements. …