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Autonomic dysreflexia

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https://www.readbyqxmd.com/read/28406070/an-investigation-of-the-relationship-between-autonomic-dysreflexia-and-intrathecal-baclofen-in-patients-with-spinal-cord-injury
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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...
February 4, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28161248/how-is-chronic-pain-related-to-sympathetic-dysfunction-and-autonomic-dysreflexia-following-spinal-cord-injury
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/28109254/letm-presented-with-causalgia-and-ensued-by-sudden-death
#15
Rana Alnasser Alsukhni, Yasmin Aboras, Ziena Jriekh, Mahmoud Almalla, Ahmad Sheikh El-Kahwateya
BACKGROUND: Longitudinally Extensive Transverse Myelitis LETM is a specific pattern of myelitis wherein at least three continuous vertebral segments are involved. Characteristically, it is a defining feature of neuromyelitis optica NMO. However, it is described in many other etiologies. CASE PRESENTATION: We present a case of 60 year old male who presented with symptoms and signs of regional sympathetic dystrophy RSD followed by symptoms of myelitis. Spinal cord MRI revealed cervical LETM extending to the brainstem...
January 21, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28008298/severe-protracted-spasm-of-urinary-bladder-and-autonomic-dysreflexia-caused-by-changing-the-suprapubic-catheter-in-a-cervical-spinal-cord-injury-patient-treatment-by-a-bolus-dose-and-increased-total-daily-dose-of-intrathecal-baclofen
#16
Subramanian Vaidyanathan, Tun Oo, Bakul M Soni, Peter L Hughes, Gurpreet Singh
BACKGROUND: Intrathecal administration of baclofen by implanted pump reduces rigidity and muscle spasms. Its use specifically to control bladder spasms has not been reported. CASE REPORT: A tetraplegic patient developed severe, protracted, bladder spasms, abdominal muscles spasms, and high blood pressure after change of suprapubic catheter; nifedipine, diazepam, and paracetamol did not control spasms; bolus dose of baclofen intrathecally produced prompt relief via baclofen pump...
2016: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28004433/effects-of-early-and-delayed-initiation-of-exercise-training-on-cardiac-and-haemodynamic-function-after-spinal-cord-injury
#17
David W Popok, Christopher R West, Laura McCracken, Andrei V Krassioukov
What is the central question of this study? How does early versus delayed initiation of passive hindlimb cycling, as well as detraining, affect cardiac function and blood pressure control in a rodent model of spinal cord injury? What is the main finding and its importance? Early or delayed initiation of hindlimb cycling improves cardiac and haemodynamic function in spinal cord injury, although the benefits of early administration are more pronounced. We also demonstrate the need for exercise to be maintained, because detraining rapidly reverses the cardiac and haemodynamic benefits...
February 1, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28003699/an-unusual-presentation-of-autonomic-dysreflexia-in-a-patient-with-cold-abscess-of-cervical-spine-for-anterolateral-decompression
#18
Susmita Sarangi, Dipali Taneja, Bhavna Saxena
A young female having complaints of quadriparesis along with bladder and bowel involvement, diagnosed to have osseous destruction of C4, C6, C7, T2 vertebral bodies with pre- and para-vertebral abscess, was taken up for anterolateral decompression and fusion of cervical spine. She presented with anxiety, agitation, sweating and headache and was in hypertensive crisis which was refractory to antihypertensives, anxiolytics and analgesics but showed a reasonable response to intravenous dexmedetomidine and finally responded dramatically to rectal evacuation...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27909638/four-rod-instrumentation-for-treatment-of-charcot-spinal-arthropathy-causing-autonomic-dysreflexia-case-report-and-literature-review
#19
Stephanie Zyck, Gentian Toshkezi, John Pizzuti, Satya Marawar
Late complications of spinal cord injury can include Charcot arthropathy, in which spinal instability occurs as a result of repetitive trauma in the insensate spine. In rare cases, this can present as autonomic dysreflexia. We present the case of a 60-year-old man with longstanding C6 quadriplegia who presented with six months of hypertension, diaphoresis and dizziness. After an extensive workup, the patient's symptoms were attributed to autonomic dysreflexia in the setting of spinal instability from Charcot spinal arthropathy...
October 27, 2016: Curēus
https://www.readbyqxmd.com/read/27904914/testicular-infarction-in-a-patient-with-spinal-cord-injury-with-epididymitis-a-case-report
#20
Po-Cheng Hsu, William J Huang, Shih-Fong Huang
O-bjective: To describe a case of epididymitis-related testicular infarction in a patient with spinal cord injury. CASE REPORT: A 22-year-old man with a traumatic spinal cord injury (American Spinal Injury Association Impairment Scale A; neurological level, C4) developed epididymitis during hospitalization. He presented with spiking fever, autonomic dysreflexia, and increased spasticity. Physical examination revealed a rapidly progressive, firm swelling of the right hemiscrotum; however, the patient had no subjective complaint of pain owing to a loss of sensation...
January 19, 2017: Journal of Rehabilitation Medicine
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