ABSTRACT
The first documented case consistent with autonomic dysreflexia (AD) was reported by J. Hilton in 1860, described as chills and hot flushes in a patient with a C5 spinal cord injury (SCI). AD occurs in approximately 60% of cervical SCI patients and 20% of thoracic SIC patients. The most common stimulus for AD is distention of the bladder or rectum. AD has also been reported during extracorporeal shock wave lithotripsy and during childbirth. AD is classically characterized by an increase in blood pressure, which can occur suddenly, accompanied by bradycardia. Symptoms of AD usually start after the spinal shock period. However, AD can be seen at an early stage and should be considered in the differential diagnosis of patients immediately after an SCI. AD in the SCI patient generally occurs after the spinal shock phase of approximately 6–12 weeks. However, some patients may show evidence of AD before the end of spinal shock.
