Autonomic Dysreflexia After Spinal Cord Injury: Beyond the Basics

The purpose of this article is to update health care providers on recommended identification and management strategies for autonomic dysreflexia (AD), as well as an in-depth discussion of pharmacological management of AD. In addition, this article will focus on prevention strategies and less commonly recognized causes of AD. Clinical practice guidelines are available with effective evaluation and management strategies to treat individuals with spinal cord injury (SCI) presenting to health care professionals with AD. Three common yet easily overlooked causes of AD are distended urinary leg drainage bags preventing the flow of urine from the bladder, abdominal binders, and pressure injuries. Prevention strategies for those with recurrent AD include treatment with alpha-blockers. Autonomic dysreflexia is a potentially life-threatening emergency which requires quick recognition, identification of the cause, and pharmacological management as the cause is being reversed. Excellent guidelines have been developed for the evaluation and management of AD.