[AUTONOMIC DYSREFLEXIA]

Autonomic dysreflexia (AD) is a syndrome that occurs in patients with high spinal cord lesion. It is caused by activation of sympathetic nervous system by a noxious stimulus below the level of injury, usually consisting of distention and/or irritation of the bladder or constipation. Sympathetic system activation leads to blood pressure elevation because compensatory mechanisms cannot properly regulate blood pressure due to the spinal cord lesions. The most important manifestation of AD is arterial hypertension because of the possible cerebrovascular and cardiovascular complications, including death. Initial treatment consists of recognition of the symptoms and resolution of the cause. In patients with high blood pressure antihypertensive therapy is initiated (with nifedipine, captopril and nitroglycerin). Prevention is also a very important task, with the goal of influencing all possible triggers of this condition, specially micturition and colon disorders. One of the most important tasks is educating patients, their caregivers and health professionals about AD.