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Autonomic Dysreflexia

Autonomic Dysreflexia is a life-threatening condition which occurs only in individuals with spinal cord injury at T6 or higher.

Common Signs and Symptoms:

  • High blood pressure

  • Pounding headache

  • Flushing above level of spinal cord injury

  • Nasal congestion

  • Pallor or gooseflesh below level of spinal cord injury

  • Anxiety

  • Nausea

  • Metallic taste in mouth

  • Change in heart rate (note it could be low or high)


The most common causes are bladder and bowel distension, however, there are many other stimuli identified in the table below that can cause the sudden onset of excessively high blood pressure.


Is there a pressure sore, or nerve trapped?


Ensure sitting upright until BP returns to normal

Do they have ingrowing toe nails?



Is anything too tight - check and loosen 

Is clothing wet?

Are they too hot?


Is there a blockage?

Is the catheter clamped?

Is the leg bag full?

Urine infection?



Constipated or impacted?

Sacral skin breakdown?

Spinal Injuries Association provide a great factsheet and if you click on the button below, we have provided the link direct to this factsheet.

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