Document Detail

An interesting case of Autonomic Dysreflexia.
MedLine Citation:
PMID:  19997683     Owner:  NLM     Status:  In-Data-Review    
Autonomic dysreflexia (AD) is not an uncommon clinical condition and it is usually detected in patients with complete spinal injuries at or above thoracic 6th vertebral level (T 6). This condition is reported to occur in 48- 60% of cases of spinal cord injury at or above the level of T6. But AD due to injury below T6 is rare. The basic mechanism is thought to be due to excessive, uncontrolled activation of sympathetic system. In the present case, we discuss a persistent AD in 55-yr-old tetraplegic patient with C5 American Spinal Injury Association (ASIA) grade A lesion due to a fall from 10 metre height. MRI examination showed C5 and C6 bi-facets fracture and dislocation with canal compromise. Wiring and fusion was performed but recurrent mucous plugging and aspiration pneumonia and urinary tract infection happened during the hospital stay. Three months later, he was re-admitted with multiple pressure sores, pneumonia, sepsis and high blood pressure. He was administered with nifedepine but the blood pressure kept fluctuating. The present study highlights how the precipitating factors like concomitant urinary tract infection, decubitus ulcers, spasticity triggered the AD attack. The knowledge of the AD and its proper diagnosis and management may be beneficial to all clinicians and the present article attempts to highlight such.
H Ohnmar; S Das; A S Naicker
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  La Clinica terapeutica     Volume:  160     ISSN:  1972-6007     ISO Abbreviation:  Clin Ter     Publication Date:    2009 Sep-Oct
Date Detail:
Created Date:  2009-12-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372604     Medline TA:  Clin Ter     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  371-3     Citation Subset:  IM    
Rehabilitation Unit, Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), 471000, Malaysia.
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