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Autonomic dysreflexia

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https://www.readbyqxmd.com/read/28688623/neuropsychiatric-debut-as-a-presentation-of-guillain-barr%C3%A3-syndrome-an-atypical-clinical-case-and-literature-review
#1
Dinesh Sangroula, Richard Durrance, Shirshak Bhattarai, Thambirajah Nandakumar
INTRODUCTION: Guillain Barré Syndrome (GBS) is an acute immune-mediated polyneuropathy most frequently presenting two to four weeks after an acute mild-moderately severe infection as progressive muscular weakness of the lower limbs extending proximally with dysreflexia and autonomic dysfunction. While GBS is typically believed to be isolated to the Peripheral Nervous System, Central Nervous System (CNS) and psychiatric manifestations as a sequela of the disease have been described in different imaging and clinical studies...
July 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28618110/intravesical-vanilloids-for-treating-neurogenic-lower-urinary-tract-dysfunction-in-patients-with-multiple-sclerosis-a-systematic-review-and-meta-analysis-a-report-from-the-neuro-urology-promotion-committee-of-the-international-continence-society-ics
#2
REVIEW
Véronique Phé, Marc P Schneider, Benoit Peyronnet, Nadim Abo Youssef, Livio Mordasini, Emmanuel Chartier-Kastler, Lucas M Bachmann, Thomas M Kessler
AIMS: To systematically assess all available evidence on efficacy and safety of vanilloids for treating neurogenic lower urinary tract dysfunction (NLUTD) in patients with multiple sclerosis (MS). METHODS: This systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were identified by electronic search of Cochrane register, Embase, Medline, Scopus, (last search January 8, 2016)...
June 15, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28585557/pharmacodynamics-and-effectiveness-of-topical-nitroglycerin-at-lowering-blood-pressure-during-autonomic-dysreflexia
#3
R Solinsky, A E Bunnell, T A Linsenmeyer, J N Svircev, A Engle, S P Burns
STUDY DESIGN: Secondary analysis of prospectively collected observational data assessing the safety of an autonomic dysreflexia (AD) management protocol. OBJECTIVES: To estimate the time to onset of action, time to full clinical effect (sustained systolic blood pressure (SBP) <160 mm Hg) and effectiveness of nitroglycerin ointment at lowering blood pressure for patients with spinal cord injuries experiencing AD. SETTING: US Veterans Affairs inpatient spinal cord injury (SCI) unit...
June 6, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28506502/autonomic-dysreflexia-after-spinal-cord-injury-systemic-pathophysiology-and-methods-of-management
#4
REVIEW
Khalid C Eldahan, Alexander G Rabchevsky
Traumatic spinal cord injury (SCI) has widespread physiological effects beyond the disruption of sensory and motor function, notably the loss of normal autonomic and cardiovascular control. Injury at or above the sixth thoracic spinal cord segment segregates critical spinal sympathetic neurons from supraspinal modulation which can result in a syndrome known as autonomic dysreflexia (AD). AD is defined as episodic hypertension and concomitant baroreflex-mediated bradycardia initiated by unmodulated sympathetic reflexes in the decentralized cord...
May 8, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28486884/effect-of-intravesical-botulinum-toxin-injection-on-symptoms-of-autonomic-dysreflexia-in-a-patient-with-chronic-spinal-cord-injury-a-case-report
#5
Il-Young Jung, Kyo Ik Mo, Ja-Ho Leigh
CONTEXT: There are few treatment options for managing autonomic dysreflexia in patients with chronic spinal cord injury (SCI). According to some studies, intravesical botulinum toxin for SCI patients with autonomic dysreflexia has a preventive effect on symptoms of autonomic dysreflexia. However, the usefulness of an intravesical botulinum toxin injection has never been reported for autonomic dysreflexia in an adult patient with chronic cervical SCI, although there has been for one pediatric patient...
May 9, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28457670/implications-of-altered-autonomic-control-on-sports-performance-in-athletes-with-spinal-cord-injury
#6
REVIEW
Sebastian Cruz, Cheri A Blauwet
It is well known that athletes with spinal cord injury (SCI) may experience altered autonomic physiology that impacts their exercise capacity and sports performance. This is particularly relevant given the ever-increasing number of individuals with SCI who are actively engaged in sports at all levels, from community-based adaptive sports to elite Paralympic competitions. As such, the purpose of this article is to review the present literature regarding the implications of altered autonomic control on the safety and performance of athletes with SCI...
April 4, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28406070/an-investigation-of-the-relationship-between-autonomic-dysreflexia-and-intrathecal-baclofen-in-patients-with-spinal-cord-injury
#7
Anna Sophia Del Fabro, Melvin Mejia, Gregory Nemunaitis
OBJECTIVE: To study the relationship between autonomic dysreflexia and intrathecal baclofen in patients with spinal cord injury. DESIGN: Retrospective chart review. SETTING: Inpatient and outpatient acute rehabilitation facility. PARTICIPANTS: Thirty-four subjects. INTERVENTIONS: We reviewed patients' medical records to ascertain the presence of symptomatic autonomic dysreflexia (AD) prior to and after implantation of an intrathecal baclofen (ITB) pump for spasticity in spinal cord injury patients...
April 13, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28366524/advanced-hip-osteoarthritis-causing-autonomic-dysreflexia-and%C3%A2-severe-spasticity-in-a-patient-with-spinal-cord-injury-a-case-report
#8
Brittany Bickelhaupt, Megan Richard, Michelle Trbovich
The life expectancy of persons with spinal cord injury (SCI) is increasing due to advances in medicine and technology. As a result, there is a higher incidence of age-associated illnesses in this population. Degenerative joint disease is a common age-associated illness that causes pain and thus, in persons with SCI above the T6 level, can serve as a noxious stimulus to trigger autonomic dysreflexia (AD). This is a case report of severe bilateral hip osteoarthritis (OA) causing unyielding AD in a person with tetraplegia leading to bilateral girdle stone surgeries...
March 31, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28366050/a-safe-and-effective-multi-day-colonoscopy-bowel-preparation-for-individuals-with-spinal-cord-injuries
#9
Shawn H Song, Jelena N Svircev, Brandon J Teng, Jason A Dominitz, Stephen P Burns
CONTEXT/OBJECTIVE: Colonoscopy with polypectomy is associated with a reduced risk of colorectal cancer (CRC), but poor bowel cleansing limits the diagnostic yield of the procedure. Patients with spinal cord injury (SCI) frequently have suboptimal bowel cleansing with standard pre-colonoscopy bowel preparation regimens. We aimed to assess the safety, tolerability, and efficacy of a multi-day inpatient bowel preparation regimen in a population of patients with SCI. DESIGN: Retrospective case series...
April 1, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28314966/-neuro-urological-diagnosis-and-therapy-of-lower-urinary-tract-dysfunction-in-patients-with-spinal-cord-injury-s2k-guideline-of-the-german-speaking-medical-society-of-paraplegia-dmgp-awmf-register-no-179-001
#10
R Böthig, B Domurath, A Kaufmann, J Bremer, W Vance, I Kurze
BACKGROUND: Most patients with spinal cord injury (SCI) suffer from neurogenic lower urinary tract dysfunction (NLUTD), bowel dysfunction and sexual dysfunction. If these remain untreated, severe medical complications and serious limitations (restrictions) in quality of life are imminent. OBJECTIVES: In the long term, there are considerable differences in the treatment results of highly specialized centers versus other treatment facilities. MATERIALS AND METHODS: Against this background, a consensus-based guideline, according to the AWMF (Association of the Scientific Medical Societies in Germany) criteria (S2k), was developed by the neuro-urology working group of the DMPG (German-Speaking Medical Society of Paraplegia)...
March 17, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28228335/alterations-in-cardiac-autonomic-control-in-spinal-cord-injury
#11
REVIEW
Fin Biering-Sørensen, Tor Biering-Sørensen, Nan Liu, Lasse Malmqvist, Jill Maria Wecht, Andrei Krassioukov
A spinal cord injury (SCI) interferes with the autonomic nervous system (ANS). The effect on the cardiovascular system will depend on the extent of damage to the spinal/central component of ANS. The cardiac changes are caused by loss of supraspinal sympathetic control and relatively increased parasympathetic cardiac control. Decreases in sympathetic activity result in heart rate and the arterial blood pressure changes, and may cause arrhythmias, in particular bradycardia, with the risk of cardiac arrest in those with cervical or high thoracic injuries...
February 15, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28215570/cardiac-electrophysiology-of-patients-with-spinal-cord-injury
#12
Michael Manogue, David S Hirsh, Michael Lloyd
Spinal cord injury is a clinical syndrome encountered frequently in trauma centers and is accompanied by both acute and chronic heart rhythm abnormalities. The injury is characterized by sympathetic nervous system impairment with preservation of parasympathetic output via the vagus nerve. Severe bradycardia in the form of life-threatening sinus arrest or complete heart block may be observed in the acute recovery phase. Therapy for arrhythmias in the acute phase includes atropine, intravenous chronotropes, methylxanthines for the prevention of episodic bradycardia, and pacemaker implantation in severe cases...
February 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28212120/neurogenic-voiding-dysfunction
#13
Petros Georgopoulos, Apostolos Apostolidis
PURPOSE OF REVIEW: This review aims to analyze and discuss all recently published articles associated with neurogenic voiding discussion providing readers with the most updated knowledge and trigger for further research. RECENT FINDINGS: They include the proposal of a novel classification system for the pathophysiology of neurogenic lower urinary tract dysfunction (NLUTD) which combines neurological defect in a distinct anatomic location, and data on bowel dysfunction, autonomic dysreflexia and urine biomarkers; review of patient-reported outcome measures in NLUTD; review of the criteria for the diagnosis of clinically significant urinary infections; novel research findings on the pathophysiology of NLUTD; and review of data on minimally and more invasive treatments...
May 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28209424/changes-in-sympathetic-neurovascular-function-following-spinal-cord-injury
#14
REVIEW
Hussain Al Dera, James A Brock
The effects of spinal cord injury (SCI) on sympathetic neurovascular transmission have generally been ignored. This review describes changes in sympathetic nerve-mediated activation of arterial vessels to which ongoing sympathetic activity has been reduced or silenced following spinal cord transection in rats. In all vessels studied in rats, SCI markedly enhanced their contractile responses to nerve activity. However, the mechanisms that augment neurovascular transmission differ between the rat tail artery and mesenteric artery...
February 11, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28198657/genital-nerve-stimulation-increases-bladder-capacity-after-sci-a-meta-analysis
#15
Dennis J Bourbeau, Graham H Creasey, Steven Sidik, Steven W Brose, Kenneth J Gustafson
BACKGROUND: Neurogenic detrusor overactivity (NDO) often results in decreased bladder capacity, urinary incontinence, and vesico-ureteral reflux. NDO can trigger autonomic dysreflexia and can impair quality of life. Electrical stimulation of the genital nerves (GNS) acutely inhibits reflex bladder contractions and can increase bladder capacity. Quantifying the effect of GNS on bladder capacity and determining what study factors and subject factors influence bladder capacity improvements will inform the design of clinical GNS interventions...
February 15, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28185483/genital-nerve-stimulation-is-tolerable-and-effective-for-bladder-inhibition-in-sensate-individuals-with-incomplete-sci
#16
Steven W Brose, Dennis J Bourbeau, Kenneth J Gustafson
BACKGROUND: Neurogenic detrusor overactivity after spinal cord injury (SCI) causes urinary incontinence and reduces bladder capacity. Surface electrical genital nerve stimulation (GNS) acutely inhibits reflex bladder contractions. The stimulation amplitude selected for GNS is typically twice the amplitude that is required to evoke the pudendal-anal reflex. There is concern about the ability of persons with sensation to comfortably tolerate effective levels of GNS. The objective of this work is to determine if persons with incomplete SCI are able to tolerate acute GNS for bladder inhibition...
February 10, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28174025/effects-of-liposome-based-local-suppression-of-nerve-growth-factor-in-the-bladder-on-autonomic-dysreflexia-during-urinary-bladder-distention-in-rats-with-spinal-cord-injury
#17
Katsumi Kadekawa, Tsuyoshi Yoshizawa, Naoki Wada, Takahiro Shimizu, Tsuyoshi Majima, Pradeep Tyagi, William C de Groat, Kimio Sugaya, Naoki Yoshimura
PURPOSE: To examine (1) whether spinal cord injury (SCI) time-dependently increases the severity of autonomic dysreflexia (AD) and expression levels of bladder nerve growth factor (NGF) protein, and (2) whether local suppression of NGF in the bladder improves SCI-induced AD in rats. MATERIALS AND METHODS: SCI was produced by the transection of the T2/3 spinal cord in female Sprague-Dawley rats. At 4 or 8weeks after SCI, differences in the mean arterial blood pressure (ΔMAP) and heart rate (ΔMHR) during graded increases in intravesical pressure to 20, 40 and 60cm H2O from those before bladder distention and NGF protein levels in the bladder wall were evaluated in spinal intact and SCI rats under urethane anesthesia...
May 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28161248/how-is-chronic-pain-related-to-sympathetic-dysfunction-and-autonomic-dysreflexia-following-spinal-cord-injury
#18
Edgar T Walters
Autonomic dysreflexia (AD) and neuropathic pain occur after severe injury to higher levels of the spinal cord. Mechanisms underlying these problems have rarely been integrated in proposed models of spinal cord injury (SCI). Several parallels suggest significant overlap of these mechanisms, although the relationships between sympathetic function (dysregulated in AD) and nociceptive function (dysregulated in neuropathic pain) are complex. One general mechanism likely to be shared is central sensitization - enhanced responsiveness and synaptic reorganization of spinal circuits that mediate sympathetic reflexes or that process and relay pain-related information to the brain...
January 27, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28128904/robotic-assisted-laparoscopic-augmentation-ileocystoplasty
#19
Peter A Caputo, Daniel Ramirez, Matthew Maurice, Onder Kara, Ryan Nelson, Ercan Malkoc, Jihad Kaouk
INTRODUCTION: Augmentation ileocystoplasty is a common treatment in adults with low capacity bladders due to neurogenic bladder dysfunction. We describe here our technique for robotic assisted laparoscopic augmentation ileocystoplasty in an adult with a low capacity bladder due to neurogenic bladder dysfunction. MATERIALS AND METHODS: The patient is a 35 years-old man with neurogenic bladder due to a C6 spinal cord injury in 2004. Cystometrogram shows a maximum capacity of 96cc and Pdet at maximum capacity of 97cmH2O...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28115072/complications-of-spinal-cord-injury-over-the-first-year-after-discharge-from-inpatient-rehabilitation
#20
Michael D Stillman, Jason Barber, Steve Burns, Steve Williams, Jeanne M Hoffman
OBJECTIVES: To describe the prevalence and cumulative incidence (CI) of secondary complications of spinal cord injury (SCI) in the first year after discharge from inpatient rehabilitation (IR). To evaluate potential associations between risk of complications and socio-demographic and injury-specific factors. DESIGN: Secondary analysis of data collected for a single-site, single-blind, randomized controlled trial comparing telephone follow up to usual care. SETTING: Two inpatient rehabilitation units comprising the Northwest Regional SCI System in Seattle, Washington...
January 20, 2017: Archives of Physical Medicine and Rehabilitation
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