Autonomic dysreflexia caused by cervical stenosis.

Area of Science:

• Neurology
• Neurosurgery
• Autonomic Medicine

Background:

• Autonomic dysreflexia (AD) is a common complication of high spinal cord injuries (SCI).
• AD involves episodic sympathetic overactivity, triggered by visceral stimuli, manifesting as hypertension, sweating, and altered heart rate.
• Symptoms can persist for extended periods, significantly impacting patient quality of life.

Purpose of the Study:

• To report a unique case of autonomic dysreflexia attributed to cervical stenosis.
• To highlight a potential association between spinal stenosis and AD outside of traumatic SCI.
• To raise clinical awareness of this non-SCI related cause of AD.

Main Methods:

• A case report of a 73-year-old male with cervical stenosis presenting with symptoms mimicking AD.
• Extensive diagnostic workup by cardiology, endocrinology, and neurology ruled out other pathologies.
• The patient underwent anterior cervical decompression and fusion (ACDF) at the C5-C6 level.

Main Results:

• The patient experienced long-standing symptoms of "hot flashes," dizziness, flushing, diaphoresis, and palpitations.
• Diagnosis of autonomic dysreflexia secondary to cervical spinal stenosis was established.
• Following ACDF, the patient reported near-complete resolution of autonomic symptoms.

Conclusions:

• Cervical compression may disrupt sympathetic preganglionic neuron regulation, leading to autonomic symptoms.
• This is the first reported case of AD stemming from cervical stenosis, distinct from traumatic SCI.
• Clinicians should consider spinal stenosis as a potential cause of AD in patients without a history of SCI.