How do autonomic dysreflexia symptoms manifest?

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Autonomic dysreflexia is a serious condition that commonly occurs in individuals with spinal cord injuries, particularly those with lesions at or above the T6 level. The symptoms are primarily due to a reflex sympathetic nervous system response triggered by a noxious stimulus below the level of injury.

The manifestation of severe hypertension is a hallmark symptom, arising from an exaggerated sympathetic response resulting in increased vascular resistance. This often leads to a significant rise in blood pressure. In response to this hypertension, the body attempts to activate the parasympathetic nervous system, which can cause bradycardia, or a reduced heart rate. Additionally, individuals may experience skin flushing above the level of the injury as blood vessels dilate in response to the increased blood pressure, leading to a warm sensation and altered skin color.

This specific combination of severe hypertension, bradycardia, and skin flushing is critical for identifying autonomic dysreflexia and requires immediate attention to address the underlying cause of the noxious stimulus and mitigate the dangerously high blood pressure.