Sie sind auf Seite 1von 3

AUTONOMIC HYPERREFLEXIA

is a reaction of the autonomic (involuntary) nervous system to overstimulation. This reaction may include high blood pressure, change in heart rate, skin color changes (paleness, redness, bluegrey skin color), and excessive sweating.

Symptoms
Symptoms can include any or all of the following: y y y y y y y y y y y Anxiety or apprehension (fear) Bladder or bowel dysfunction Blurry vision Fever Flushing (skin turning red) Goose bumps Heavy sweating Lightheadedness or dizziness Muscle spasm Nasal congestion Throbbing headache

Sometimes, despite a dangerous rise in blood pressure, there are no symptoms at all.

Causes & Risk Factors


The most common cause of autonomic hyperreflexia is spinal cord injury. In this condition, types of stimulation that are tolerated by healthy people create an excessive response from the person's nervous system. Other causes include medication side effects, use of illegal stimulants such ascocaine and amphetamines, Guillain-Barre syndrome (a severe form of paralysis that can lead to respiratory failure), subarachnoid hemorrhage (a form of brain bleeding), severe head trauma, and other brain injuries.

Tests & Diagnostics


y y y y Dilated pupils Flushed (red) skin above the level of the spinal cord injury High blood pressure Slow pulse or fast pulse

The doctor will do a complete neurological and medical examination. Patients must tell their doctor all medications they are currently taking and all medications they've taken in the past, to help determine which tests are necessary. Tests may include: y y y y y y y y Blood and urine tests Brain pictures including head CT or MRI EKG (measurement of the heart's electrical activity) Lumbar puncture Spine pictures, particularly MRI Tilt-table testing (testing of blood pressure regulation as body position changes) Toxicology screening (tests for any drugs, including medications, in the patient's bloodstream) X-rays

Treatments
This condition is life-threatening, so it is important to quickly identify and treat the problem. Proper treatment depends on the cause. If medications or drugs are causing the symptoms, those drugs must be stopped. Any underlying illness that is causing the symptoms needs to be treated. If a slowing of the heart rate is causing the symptoms, drugs called anticholinergics (such as atropine) may be used. Very high blood pressure needs to be treated quickly but carefully because a sudden and severe drop in blood pressure is possible, and can also cause problems. Commonly used emergency drugs for high blood pressure include:nifedipine (Procardia), nitroglycerin, phenoxybenzamine hydrochloride(Dibenzyline), mecamylamine (Inversine), and diazoxide (Hyperstat). A pacemaker may be required for certain unstable heart-related situations.

Complications
Complications may occur as a result of side effects of medications. If the pulse rate drops severely, it can cause cardiac arrest. Prolonged, severe high blood pressure may cause seizures, bleeding in the eyes, stroke, or death.

Prevention
Prevention of autonomic hyperreflexia includes avoiding medications that cause this condition or make it worse. In people with spinal cord injury, the following may also help prevent this complication: y y y y Avoid letting the bladder become too full. Keep pain levels low. Practice proper bowel care to avoid stool impaction. Practice proper skin care to avoid bedsores and skin infections.

Das könnte Ihnen auch gefallen