Syndrome of massive imbalanced reflex sympathetic discharge from strong stimulus below level of spinal lesion
Carotid and aortic baroreceptors result in strong vagal response with bradycardia and vasodilation above level of injury, but cannot inhibit sympathetics below level of injury - hypertension remains dysregulated by the CNS
Occurring in patients with spinal cord injury (SCI) above the splanchnic sympathetic outflow (T5-T6)
Splanchnic innervation from T5-T9
Lesions below T6 allow descending inhibitory PSNS control to decrease splanchnic tone, preventing hypertension
Medical emergency given dangerous sequelae of elevated blood pressure
Bladder distension ~80%
Bowel distension, fecal impaction ~15%
Pressure ulcers
Autonomic dysreflexia
Hypertensive emergency
Focal neurologic deficits
Stroke
Gastroparesis
Sympathetic crashing acute pulmonary edema
Tick paralysis
Ischemic stroke