We have located links that may give you full text access.
Case Reports
Journal Article
Autonomic dysreflexia following acute myelitis due to neuromyelitis optica.
Multiple Sclerosis and related Disorders 2018 July
BACKGROUND: Cardiovascular autonomic dysfunction is a relatively common secondary complication of tetraplegia. In addition to low baseline arterial blood pressure, tetraplegics can develop sudden-onset hypertensive episodes associated with a variety of symptoms and signs (so-called autonomic dysreflexia). Unfortunately, this potentially life-threatening medical entity is often overlooked and mismanaged. With this, a case of typical presentation of autonomic dysreflexia in an individual with acute severe cervical spinal cord impairment due to neuromyelitis optica (NMO) is reported and discussed.
CASE REPORT: A 60-year-old, Asian woman developed a rapidly progressive tetraplegia associated with neurogenic bladder and bowel, and cardiovascular autonomic dysfunction due to NMO. In addition to low baseline blood pressure and orthostatic hypotension, the patient developed episodes of autonomic dysreflexia during the acute stage following C2 motor complete tetraplegia. The episodes of autonomic dysreflexia resolved after fecal disimpaction. Her blood pressure stabilized after fecal disimpaction, even though occasional, milder episodes of autonomic dysreflexia occurred during bowel routines in the acute and subacute stages after tetraplegia. Her cardiovascular function normalized as she also regained motor and sensory function in the chronic stage after initial flare of NMO.
CONCLUSIONS: This case report illustrates a clinically relevant, but still under-recognized cardiovascular autonomic complication of severe, cervical or high-thoracic spinal cord impairment due to NMO. In addition to low baseline blood pressure and orthostatic hypotension, the patient developed episodes of autonomic dysreflexia during the acute stage after tetraplegia. Autonomic dysreflexia requires early diagnosis and proper treatment in order to prevent severe complications or death. Greater awareness of this potentially life-threatening cardiovascular emergency of spinal cord impairment is needed among patients, caregivers, and healthcare professionals, including neurologists.
CASE REPORT: A 60-year-old, Asian woman developed a rapidly progressive tetraplegia associated with neurogenic bladder and bowel, and cardiovascular autonomic dysfunction due to NMO. In addition to low baseline blood pressure and orthostatic hypotension, the patient developed episodes of autonomic dysreflexia during the acute stage following C2 motor complete tetraplegia. The episodes of autonomic dysreflexia resolved after fecal disimpaction. Her blood pressure stabilized after fecal disimpaction, even though occasional, milder episodes of autonomic dysreflexia occurred during bowel routines in the acute and subacute stages after tetraplegia. Her cardiovascular function normalized as she also regained motor and sensory function in the chronic stage after initial flare of NMO.
CONCLUSIONS: This case report illustrates a clinically relevant, but still under-recognized cardiovascular autonomic complication of severe, cervical or high-thoracic spinal cord impairment due to NMO. In addition to low baseline blood pressure and orthostatic hypotension, the patient developed episodes of autonomic dysreflexia during the acute stage after tetraplegia. Autonomic dysreflexia requires early diagnosis and proper treatment in order to prevent severe complications or death. Greater awareness of this potentially life-threatening cardiovascular emergency of spinal cord impairment is needed among patients, caregivers, and healthcare professionals, including neurologists.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app