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Autonomic hyperreflexia - Treatment

Treatment:

This condition is life-threatening, so it is important to quickly identify and treat the problem.

A person with symptoms of autonomic hyperreflexia should:

  • Sit up and raise their head
  • Remove tight clothing

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. For example, the health care provider will check for a blocked urinary catheter and signs of constipation.

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.

Expectations (prognosis):

The outlook depends on the underlying cause. People with autonomic hyperreflexia due to medications usually recover when the medications that are causing the symptoms are stopped. When the condition is caused by other factors, recovery depends on the success of treating the underlying disease.

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.

Calling your health care provider:

Call your health care provider if you have symptoms of autonomic hyperreflexia.

  • Reviewed last on: 6/16/2010
  • David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital.

References

Khastgir J, Drake MJ, Abrams P. Recognition and effective management of autonomic dysreflexia in spinal cord injuries. Expert Opin Pharmacother. 2007;8:945-956.

Kirshblum SC, Priebe MM, Ho CH, Scelza WM, Chiodo AE, Wuermser LA. Spinal cord injury medicine: 3. Rehabilitation phase after acute spinal cord injury. Arch Phys Med Rehabil. 2007;88:S62-S70.

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