Autonomic dysreflexia in acute disseminated encephalomyelitis
Machinary P Jayakrishnan1, Padinharath Krishnakumar, Rajendran Gauthamen
1Department of Pediatrics, Institute of Maternal and Child Health, Medical College, Calicut, Kerala, India. mp.jayakrishnan@gmail.com
Pediatric Neurology
|September 12, 2012
Summary
Autonomic dysreflexia, a condition in spinal cord injury patients, can be triggered by stimuli below the injury. Prompt recognition and removal of the trigger, like a blocked catheter, can be life-saving.
Area of Science:
- Neurology
- Cardiology
- Urology
Background:
- Autonomic dysreflexia is a common complication in spinal cord injury (SCI) patients.
- It results from an exaggerated sympathetic response to stimuli below the level of SCI.
- This condition can lead to dangerous hypertension and other cardiovascular events.
Observation:
- An 11-year-old boy with acute disseminated encephalomyelitis (ADEM) and spinal cord involvement presented with autonomic dysreflexia symptoms.
- Symptoms included intense flushing and sweating of the head and neck, hypertension, and tachycardia.
- These episodes resolved after a partially blocked bladder catheter was changed.
Findings:
- The clinical presentation strongly suggested autonomic dysreflexia in a patient with ADEM and SCI.
- A blocked bladder catheter was identified as the likely precipitating noxious stimulus.
- Resolution of symptoms upon catheter management confirmed the diagnosis and trigger.
Implications:
- Early recognition of autonomic dysreflexia is crucial for patient safety.
- Identifying and removing the precipitating trigger, such as urinary issues, can be life-saving.
- This case highlights the importance of considering autonomic dysreflexia in SCI patients with ADEM, even in younger individuals.
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