Autonomic dysreflexia

from Wikipedia, the free encyclopedia
Classification according to ICD-10
G90.4- Group: Autonomic Dysreflexia
ICD-10 online (WHO version 2019)

An Autonomous dysreflexia is a medical emergency typically in patients with Querschnittläsion above Th6 or quadriplegia occurs. Patients with severe head trauma , subarachnoid hemorrhage , Guillain-Barré syndrome , drug abuse of cocaine and amphetamines, and lesions below Th10 who have experienced autonomic dysreflexia have also been reported.

root cause

The regulation of blood pressure below the lesion is disturbed by the damaged nerve cords . Stimuli such as pain , a full urinary bladder or a full intestine now lead to a rapid narrowing of the blood vessels and thus an increase in blood pressure. Signals that are supposed to regulate the vessel width again do not come to the destination due to the disturbed transmission of stimuli through the lesion. This results in increased blood pressure in the area below the lesion - the body tries to regulate this with a slowed pulse and vasodilatation above the lesion.

Clinical manifestations

Symptoms of autonomic dysreflexia are:

  • strong headache
  • sweat
  • low pulse
  • high blood pressure
  • Seizures
  • cold sweaty skin above the lesion

treatment

To treat autonomic dysreflexia, the irritating factors (such as a full urinary bladder, pain, etc.) are first eliminated, and the patient should sit upright and lower their legs. A rapid reduction in blood pressure by administering z. B. to achieve nifedipine or nitroglycerine .

prevention

To avoid acute autonomic dysreflexia, blood pressure should be checked regularly to avoid rashes. Bladder and bowel training is also recommended to reduce the risk of over-stimulation.

Individual evidence

  1. ↑ a b c Pschyrembel Online. Retrieved August 13, 2019 .
  2. ↑ J. Vidal, E. Portell, J. Benito, M. Vallès: Cerebral hemorrhage due to autonomic dysreflexia in a spinal cord injury patient . In: Spinal Cord . tape 43 , no. December 12 , 2005, ISSN  1476-5624 , pp. 738–740 , doi : 10.1038 / sj.sc.3101780 ( nature.com [accessed August 13, 2019]).
  3. ↑ Autonomic dysreflexia: MedlinePlus Medical Encyclopedia. Accessed August 13, 2019 .
  4. ↑ a b c What happens with autonomic dysreflexia? Retrieved on August 13, 2019 (German).
  5. ^ A b Autonomous dysreflexia. Retrieved August 13, 2019 .
  6. ^ SP Burns, A. Engle, JN Svircev, TA Linsenmeyer, AE Bunnell: Pharmacodynamics and effectiveness of topical nitroglycerin at lowering blood pressure during autonomic dysreflexia . In: Spinal Cord . tape 55 , no. October 10 , 2017, ISSN  1476-5624 , p. 911–914 , doi : 10.1038 / sc.2017.58 ( nature.com [accessed August 13, 2019]).