An emergency issue in paralysis is Autonomic Dysreflexia more often called AD. This can occur in individuals with spinal cord injury from trauma OR disease, or with head injury. It is a condition where an individual’s blood pressure suddenly rises to or above 20mm Hg (mercury) in adults or 15 mm Hg in children over their normal blood pressure. That is 20 points or higher in adults and 15 points higher or more in children in the top number of the individual’s normal average blood pressure.
AD occurs because something is irritating the individual in the paralyzed part of the body. This message is not clearly sent or interpreted by the brain resulting in an ‘all out’ release of messages from the brain to try to resolve the unclear issue. The result is an elevation in blood pressure which can have damaging effects on the cardiovascular system including the heart and blood vessels. Left untreated, AD can result in stroke or even death.
AD can occur in individuals with spinal cord injury at or above T6 but has been noted in those with injuries as low as T10. Not everyone with spinal cord injury will have AD. It develops after spinal shock resolves which can be up to six months after injury. In those with spinal cord injury from disease, AD may or may not develop as the disease progresses. In head injury, AD occurs if the autonomic nervous system is affected.
New research has demonstrated that individuals can have silent AD where the blood pressure rises but no symptoms are felt. Silent AD can even occur when sleeping.
Know your individual blood pressure by measuring it at home during various activities. Have it measured by someone even occasionally when asleep. Your individual average will become apparent. That way you will know when your blood pressure is suddenly elevated over your normal.