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Autonomic dysreflexia

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https://www.readbyqxmd.com/read/28782691/first-case-of-autonomic-dysrefleixa-following-elective-lower-thoracic-spinal-cord-transection-in-a-spina-bifida-adult
#1
Juanita Garces, Mansour Mathkour, Tyler Scullen, Lora Kahn, Erin Biro, Olawale A R Sulaiman, Roger Smith, Cuong J Bui
BACKGROUND: Spinal cord transection is a radical but effective treatment for highly selective cases of symptomatic spinal re-tethering in paraplegic spina bifida patients. Autonomic dysreflexia (AD) is a potentially life-threatening syndrome involving a dysregulated sympathetic discharge reflex commonly seen following cervical and high thoracic spinal cord injury leading to a disconnect between autonomic pathways above and below the lesion that can lead to severe complications including uncontrolled hypertension, bradycardia, stroke, and potentially death...
August 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28751978/intracerebral-haemorrhage-following-uncontrolled-autonomic-dysreflexia-post-suprapubic-catheter-placement-surgery
#2
Mazatulfazura Sf Salim, Mazlina Mazlan, Nazirah Hasnan
INTRODUCTION: We describe a case of intracerebral haemorrhage (ICH) following uncontrolled episodes of autonomic dysreflexia (AD) within 24 h of a minor urological procedure. CASE PRESENTATION: A 33-year-old active paraplegic patient T1 Association Impairment Scale A underwent an elective suprapubic catheter (SPC) placement for bladder management. The surgery was done under general anaesthesia and was uneventful. Four hours after surgery, he developed haematuria and multiple blood clots in the urine, which eventually caused blockage of the SPC and resulted in symptomatic AD...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28742157/angiotensin-ii-system-in-the-nucleus-tractus-solitarii-contributes-to-autonomic-dysreflexia-in-rats-with-spinal-cord-injury
#3
Kai Wang, Shaoxia Duan, Xueping Wen, Weizhong Wang, Shangping Fang, Dunyi Qi, Xiang Huan, Liwei Wang, Zhenzhou He
BACKGROUND: Autonomic dysreflexia (AD) is a potentially life-threating complication after spinal cord injury (SCI), characterized by episodic hypertension induced by colon or bladder distension. The objective of this study was to determine the role of impaired baroreflex regulation by the nucleus tractus solitarii(NTS) in the occurrence of AD in a rat model. METHODS: T4 spinal cord transection animal model was used in this study, which included 40 Male rats Colorectal distension (CD) was performed to assess AD and compare the changes of BP, HR, and BRS, six weeks after operation...
2017: PloS One
https://www.readbyqxmd.com/read/28728939/autonomic-dysreflexia-somatosympathetic-and-viscerosympathetic-vasoconstrictor-responses-to-innocuous-and-noxious-sensory-stimulation-below-lesion-in-human-spinal-cord-injury
#4
Rachael Brown, Alexander R Burton, Vaughan G Macefield
Autonomic dysreflexia is a dangerous elevation in blood pressure in people with spinal cord injury (SCI), produced by a spinally-mediated reflex activation of sympathetic vasoconstrictor neurones supplying skeletal muscle and the gut. Current dogma states that, apart from visceral inputs - such as those originating from a distended bladder or impacted colon - autonomic dysreflexia is triggered by noxious inputs below the lesion. However, while selective stimulation of small-diameter afferents in muscle or skin evokes a sustained increase in muscle sympathetic nerve activity and blood pressure, and a transient increase in skin sympathetic nerve activity and decrease in skin blood flow in able-bodied subjects, such noxious inputs have no effects on blood pressure and skin blood flow in SCI individuals...
July 13, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28688623/neuropsychiatric-debut-as-a-presentation-of-guillain-barr%C3%A3-syndrome-an-atypical-clinical-case-and-literature-review
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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