Treatment Of Autonomic Dysreflexia Research Articles

Autonomic dysreflexia following spinal cord injury

Autonomic dysreflexia (AD) is one of the most common, yet most life-threatening, complication to occur following a spinal cord injury (SCI), at or above thoracic level six (T6). The main symptom of AD is a sudden and severe rise in blood pressure, which could cause death if untreated. Healthcare providers should be informed and familiar with the diagnosis and treatment of AD. It is important to note that most SCI patients, once discharged from rehabilitation hospitals, are managed at their own homes or a community rehabilitation setting, such as care, residential or nursing homes. Often, owing to the rapid onset and severity of the symptoms of AD, people with a SCI who develop AD are often admitted to the nearest local health facility, which may be staffed by healthcare professionals who have little or no knowledge or experience in managing AD. This article will offer very clear information regarding the causes, pathophysiology, symptoms and management of AD.

Improving PM&R Resident Knowledge and Confidence About Autonomic Dysreflexia in Inpatient Spinal Cord Injury Patients

Research Objectives To improve Physical Medicine & Rehabilitation (PMR) resident medical knowledge and confidence in diagnosing and treating Autonomic Dysreflexia (AD) in Spinal Cord Injury patients admitted to an acute inpatient rehabilitation unit. Design Pre-test-post-test design. Setting MR Residency Program at an academic medical center. Participants 24 PM&R residents. Interventions Residents received simulation training on AD in 4 different clinical presentations using separate high-fidelity manikins in a small (3-4) group setting followed by 1 hour of didactic session on AD on a separate date. Main Outcome Measures Resident confidence on diagnosis and treatment of AD measured using a pre- and post-test survey. Responses were scored using Likert scale with 1 being “not at all confident” and 5 being “very confident”. Results For the six PGY-2 residents, a comparison of survey results before simulation and after simulation yielded significant increases in the confidence of their responses to each question asked (except the question regarding understanding of the pathophysiology of autonomic dysreflexia). In a post simulation comparison of survey responses between PGY-2 residents and senior resident there was no significant difference in the confidence of responses between the different resident levels. Conclusions Our study demonstrates the benefits of utilizing simulation training to improve clinical confidence through simulated application of trainee medical knowledge. The lack of significant difference in confidence level in the post stimulation survey responses between PGY-2 and senior residents highlights the value of simulation training for new trainees in orienting them to medical management of AD. High-fidelity manikins are an innovative and interactive educational tool that should be used to augment standard didactic and bedside teaching. Author(s) Disclosures None. To improve Physical Medicine & Rehabilitation (PMR) resident medical knowledge and confidence in diagnosing and treating Autonomic Dysreflexia (AD) in Spinal Cord Injury patients admitted to an acute inpatient rehabilitation unit. Pre-test-post-test design. MR Residency Program at an academic medical center. 24 PM&R residents. Residents received simulation training on AD in 4 different clinical presentations using separate high-fidelity manikins in a small (3-4) group setting followed by 1 hour of didactic session on AD on a separate date. Resident confidence on diagnosis and treatment of AD measured using a pre- and post-test survey. Responses were scored using Likert scale with 1 being “not at all confident” and 5 being “very confident”. For the six PGY-2 residents, a comparison of survey results before simulation and after simulation yielded significant increases in the confidence of their responses to each question asked (except the question regarding understanding of the pathophysiology of autonomic dysreflexia). In a post simulation comparison of survey responses between PGY-2 residents and senior resident there was no significant difference in the confidence of responses between the different resident levels. Our study demonstrates the benefits of utilizing simulation training to improve clinical confidence through simulated application of trainee medical knowledge. The lack of significant difference in confidence level in the post stimulation survey responses between PGY-2 and senior residents highlights the value of simulation training for new trainees in orienting them to medical management of AD. High-fidelity manikins are an innovative and interactive educational tool that should be used to augment standard didactic and bedside teaching.

Noninvasive Neuroprosthesis Promotes Cardiovascular Recovery After Spinal Cord Injury

Spinal cord injury (SCI) leads to severe impairment in cardiovascular control, commonly manifested as a rapid, uncontrolled rise in blood pressure triggered by peripheral stimuli—a condition called autonomic dysreflexia. The objective was to demonstrate the translational potential of noninvasive transcutaneous stimulation (TCS) in mitigating autonomic dysreflexia following SCI, using pre-clinical evidence and a clinical case report. In rats with SCI, we show that TCS not only prevents the instigation of autonomic dysreflexia, but also mitigates its severity when delivered during an already-triggered episode. Furthermore, when TCS was delivered as a multisession therapy for 6 weeks post-SCI, the severity of autonomic dysreflexia was significantly reduced when tested in the absence of concurrent TCS. This treatment effect persisted for at least 1 week after the end of therapy. More importantly, we demonstrate the clinical applicability of TCS in treatment of autonomic dysreflexia in an individual with cervical, motor-complete, chronic SCI. We anticipate that TCS will offer significant therapeutic advantages, such as obviating the need for surgery resulting in reduced risk and medical expenses. Furthermore, this study provides a framework for testing the potential of TCS in improving recovery of other autonomic functions such lower urinary tract, bowel, and sexual dysfunction following SCI.

Design and characterisation of an amorphous formulation of nifedipine for the treatment of autonomic dysreflexia.

Current treatment for autonomic dysreflexia (AD) involves rupturing a liquid-filled soft capsule of nifedipine to aid rapid drug release and absorption, however, this application is not covered under the manufacturer's license. The objective of the current work was to design a rapidly dissolving solid dosage formulation for the treatment of AD as an alternative to the off-license "bite and swallow" use of currently available commercial products. Amorphous solid dispersions (ASDs) of nifedipine were prepared by spray-drying using three different polymers: hydroxypropyl methyl cellulose (HPMC), polyvinyl pyrrolidone (PVP) and polyvinyl caprolactam-polyvinyl acetate-polyethylene glycol (Soluplus), at a 15% w/w drug loading and were formulated and compressed into tablets. Dissolution testing was performed in the paddle dissolution apparatus using either a monophasic or biphasic medium. The PVP-nifedipine ASD tablets exhibited rapid dissolution, with 35% of the total nifedipine dose dissolving within 15 min in the monophasic dissolution medium. The HPMC-nifedipine ASD exhibited a very slow dissolution, while the Solupus-nifedipine system exhibited no nifedipine release over 120 min. When tested in the biphasic dissolution medium, the PVP-nifedipine ASD tablets exhibited a release profile comparable to that of the pre-split/ruptured nifedipine soft capsule product. This study demonstrates that a nifedipine-PVP ASD is a promising formulation strategy in the treatment of AD.

Prevention of recurrent autonomic dysreflexia: a survey of current practice

There is a dearth of literature on the treatment of chronic recurrent autonomic dysreflexia (AD), a well-known complication of spinal cord injury that can have life-threatening implications. This study sought to identify clinical practices regarding the treatment of AD, both acute and recurrent, in patients with spinal cord injury (SCI). Online survey regarding AD management in SCI composed of 11 questions designed to obtain information on respondent characteristics, AD treatment options, and causes of AD. Veterans Administration health care system. Veterans Health Administration National SCI Staff Physicians were sent an electronic email to participate in the anonymous web-based survey. None applicable. The response rate was 52%. The most commonly prescribed medications for minor and severe acute manifestations of AD were nitrates. For recurrent AD, clonidine was the most commonly prescribed medication. Anti-hypertensive medications continue to be the mainstay in the management of both acute and chronic recurrent AD. Current literature is lacking in prospective randomized controlled trials investigating the relative efficacy of AD interventions. Evidence-based practice guidelines are necessary to improve clinical care.

Prazosin: a potential new management tool for iatrogenic autonomic dysreflexia in individuals with spinal cord injury?

Prazosin: a potential new management tool for iatrogenic autonomic dysreflexia in individuals with spinal cord injury?

Autonomic dysreflexia during urodynamics in children and adolescents with spinal cord injury or severe neurologic disease

Autonomic dysreflexia (AD) is a well-established association of high spinal cord injury (SCI), particularly in those occurring above T6. When a noxious stimulus is encountered, the body responds by stimulating an increase in blood pressure, which is then countered by vasodilation. In patients with autonomic dysreflexia, the patient is unable to vasodilate below the level of spinal injury due to interruption of the autonomic innervation below the injury. This then leads to persistently elevated blood pressure causing uncoordinated autonomic responses such as headache, flushing, sweating, and even hypertensive crisis. The noxious stimulus most commonly reported is bladder or bowel distention [1]. This potential trigger is especially important since many patients with SCI require catheterization and repeated urodynamic testing, both of which predispose them to bladder distention. In response to an incident during which a patient developed severe hypertension during UDS, institutional concern was raised about the potential risk of AD in other patients with SCI ≥ T8 and other severe neurological disease undergoing urodynamic testing, and a protocol was initiated in 2007 for monitoring for AD during UDS. Although no long-term complication was encountered in this incident, the need for improvement in our understanding of the detection and treatment of AD during urodynamic testing was highlighted. However, due to the potential of UDS to trigger AD and possible subsequent severe cardiovascular crisis, a protocol was established at our institution. Because of reports documenting episodes of AD for patients with severe, non-SCI neurologic disease and the unknown risk, these patients also were historically monitored at our institution as well. Autonomic dysreflexia (AD) is an uncoordinated autonomic response seen in patients with spinal cord injury (SCI). AD is often triggered by bladder distention, which may occur during urodynamic studies (UDS), and has potentially life-threatening consequences. Our purpose is to determine the prevalence and associated factors of AD in children undergoing UDS with either SCI or other neurological disease. We identified 13 pediatric patients with SCI at the eighth thoracic vertebrae or above (SCI ≥ T8) or other severe neurological disorder with urodynamic evaluations between 2007 and 2011 at our institution. We retrospectively reviewed these patients for age, gender, bladder volume, bladder compliance, detrusor instability, symptoms of AD, blood pressure, and urinary infection. There were a total of 13 patients with SCI ≥ T8 (9), transverse myelitis (2), and encephalomyelitis (2). There were a total of 41 urodynamic studies with an average of 3.2 studies per patient. One adolescent with C1/2 injury and a prepubertal child with T2/3 injury developed AD. AD was not observed in non-SCI patients. The patients who developed AD had multiple subsequent episodes with follow up UDS. No statistical associations were found for the variables evaluated. No major complications occurred, and AD was successfully managed conservatively. With appropriate monitoring and education, AD is easily recognized and managed conservatively. We found an increased risk of patients developing subsequent AD episodes after an initial episode. Patients who did not have autonomic dysreflexia during initial UDS did not experience autonomic dysreflexia on subsequent UDS. We did not observe autonomic dysreflexia occurring in children with transverse myelitis or encephalomyelitis.

Pregnancy and spinal cord injury

Key content Pregnancy exacerbates most problems associated with spinal cord injury (SCI). Diagnosis of labour in women with spinal cord injury above T10 of the spinal cord can be challenging. Women with SCI should aim for a vaginal delivery. Autonomic dysreflexia is life threatening and requires immediate treatment. Early epidural analgesia in labour will reduce the incidence of autonomic dysreflexia. Learning objectives Antenatal management of women with SCI. Care of a woman in labour. Diagnosis and treatment of autonomic dysreflexia. Ethical issues Women with chronic SCI are knowledgeable about the management of their disability, at times more than the attending medical personnel. Not listening to them may undermine the confidence they have in their care. Women with SCI are concerned that a spinal or epidural analgesia may cause further injury to their spinal cord.

Autonomic dysreflexia: An important cardiovascular complication in spinal cord injury patients

Autonomic dysreflexia (AD) is a life-threatening complication of spinal cord injury (SCI) at T6 or above that results in an uncontrolled sympathetic discharge in response to noxious stimuli. It is a symptom complex characterized by a lethal rise in blood pressure with dangerous consequences. Autonomic dysreflexia is often secondary to urological, gastrointestinal, or gynecological problems or manipulations. Early recognition and prompt treatment of AD is vital to prevent complications, including death. Its management starts primarily with its prevention. Easy measures can avoid this high risk event, and physicians should be aware of the simple procedures and the possible treatment cascade that could be undertaken. The purpose of this systematic review is to review the clinical data on the mechanisms and pathophysiology of this condition and the clinical evidence about the various strategies currently used to prevent and manage AD in the SCI population; and to improve awareness of AD among cardiologists, family physicians and medical personnel in the emergency department.

Cerebral hemorrhage due to autonomic dysreflexia in a spinal cord injury patient

Case report. To report an uncommon case of cerebral hemorrhage due to autonomic dysreflexia (AD) in a spinal cord injury (SCI) patient. Institut Guttmann, Neurorehabilitation Hospital in Barcelona, Spain. An SCI patient developed AD due to urinary tract infection after surgery for a pressure sore. The hypertension was difficult to control and the case progressed to hypertensive encephalopathy. MRI of the brain was performed showing a hemorrhagic lesion on the left occipital area. The hypertension was finally controlled and the neurological status improved although with some cognitive deficits. This is an uncommon case of cerebral hemorrhage due to AD, showing the importance of an adequate diagnosis and treatment of AD to avoid this life-threatening complication.

Beta blockade in the treatment of autonomic dysreflexia: A case report and review

Autonomic dysreflexia has long been considered a sympathetically mediated phenomenon. Recent articles have reported the use of alpha blockers as a means of treatment. We report the case of a 20-year-old CS American Spinal Injury Association A spinal cord injured patient who almost daily experienced symptoms of headache, facial flushing, and hypertension consistent with autonomic dysreflexia. These symptoms caused him frequent discomfort and anxiety. Despite an extensive workup, we were unable to identify a source of his dysreflexic episodes. After starting metoprolol 50mg every night, however, these episodes stopped and the patient showed no adverse effects from the medication.

Long-term follow-up of sphincterotomy in the treatment of autonomic dysreflexia.

Autonomic dysreflexia (AD) is a syndrome affecting a majority of patients with high spinal cord lesions. An association between AD and detrusor-sphincter dyssynergia (DSD) is often seen. Between 1980 and 1988 we performed 51 transurethral sphincterotomies in 38 patients. Twelve of these patients underwent procedures primarily for the prevention of AD related to bladder distension. This study presents their long-term follow-up. One patient was lost to follow-up secondary to unrelated death; the remaining 11 patients were followed on average 117.5 months (94-154) after the initial operative procedure. Repeat sphincterotomy was required in 9 of 11 patients (82%). Six (66%) of these were performed within 24 months. One patient (11%) required delayed sphincterotomy greater than 100 months from the initial procedure. Overall, sphincterotomy was successful in controlling symptoms of AD in 10 of 11 (91%) patients. No major complications were recorded. Sphincterotomy is a safe and effective treatment for AD associated with DSD, however long-term urologic follow-up and management are necessary.

The role of cutaneous afferent during tendon vibration stimulus between the biceps and triceps muscles

Autonomic dysreflexia (AD) is a well-established association of high spinal cord injury (SCI), particularly in those occurring above T6. When a noxious stimulus is encountered, the body responds by stimulating an increase in blood pressure, which is then countered by vasodilation. In patients with autonomic dysreflexia, the patient is unable to vasodilate below the level of spinal injury due to interruption of the autonomic innervation below the injury. This then leads to persistently elevated blood pressure causing uncoordinated autonomic responses such as headache, flushing, sweating, and even hypertensive crisis. The noxious stimulus most commonly reported is bladder or bowel distention [1]. This potential trigger is especially important since many patients with SCI require catheterization and repeated urodynamic testing, both of which predispose them to bladder distention.In response to an incident during which a patient developed severe hypertension during UDS, institutional concern was raised about the potential risk of AD in other patients with SCI ≥ T8 and other severe neurological disease undergoing urodynamic testing, and a protocol was initiated in 2007 for monitoring for AD during UDS. Although no long-term complication was encountered in this incident, the need for improvement in our understanding of the detection and treatment of AD during urodynamic testing was highlighted. However, due to the potential of UDS to trigger AD and possible subsequent severe cardiovascular crisis, a protocol was established at our institution. Because of reports documenting episodes of AD for patients with severe, non-SCI neurologic disease and the unknown risk, these patients also were historically monitored at our institution as well.Autonomic dysreflexia (AD) is an uncoordinated autonomic response seen in patients with spinal cord injury (SCI). AD is often triggered by bladder distention, which may occur during urodynamic studies (UDS), and has potentially life-threatening consequences. Our purpose is to determine the prevalence and associated factors of AD in children undergoing UDS with either SCI or other neurological disease.We identified 13 pediatric patients with SCI at the eighth thoracic vertebrae or above (SCI ≥ T8) or other severe neurological disorder with urodynamic evaluations between 2007 and 2011 at our institution. We retrospectively reviewed these patients for age, gender, bladder volume, bladder compliance, detrusor instability, symptoms of AD, blood pressure, and urinary infection.There were a total of 13 patients with SCI ≥ T8 (9), transverse myelitis (2), and encephalomyelitis (2). There were a total of 41 urodynamic studies with an average of 3.2 studies per patient. One adolescent with C1/2 injury and a prepubertal child with T2/3 injury developed AD. AD was not observed in non-SCI patients. The patients who developed AD had multiple subsequent episodes with follow up UDS. No statistical associations were found for the variables evaluated. No major complications occurred, and AD was successfully managed conservatively.With appropriate monitoring and education, AD is easily recognized and managed conservatively. We found an increased risk of patients developing subsequent AD episodes after an initial episode. Patients who did not have autonomic dysreflexia during initial UDS did not experience autonomic dysreflexia on subsequent UDS. We did not observe autonomic dysreflexia occurring in children with transverse myelitis or encephalomyelitis.

AUTONOMIC DYSREFLEXIA

Autonomic dysreflexia (AD) is a syndrome that often occurs in patients with spinal cord injuries above T-6 and can have life-threatening results if not properly managed. The hypertension associated with AD can cause a great deal of morbidity and mortality, requiring quick and effective blood pressure reduction. Both pharmacologic and nonpharmacologic methods are used to prevent or alleviate the symptoms associated with an acute episode of AD. We found that current literature is lacking in controlled, prospective, randomized studies comparing the efficacy of various medications used in the treatment of AD. We conducted a nationwide survey to determine the consensus among clinicians concerning the management of AD. The survey was designed to determine the current clinical status of AD, to assess methods of treatment being used and to summarize and give a rationale for the drugs most commonly prescribed. Finally, a suggestion for a wallet-sized card briefly outlining effective treatments of AD in an emergency situation is included. Results indicate that most clinicians feel that after nonpharmacologic measures have failed, antihypertensive medication is useful in controlling the symptoms of AD while the inciting cause is being found and treated. Agents used most frequently include, but are not limited to, nifedipine, phenoxybenzamine, prazosin, mecamylamine and nitrates.

Neurogenic Bladder Simplified

Neurogenic bladder dysfunction, if not properly diagnosed and treated, can lead to rapid deterioration of renal function by compromise of the upper urinary tracts. Two major categories of neurogenic bladder (detrusor hyperreflexia areflexia) have been discussed including the pathophysiology of the voiding dysfunction and the typical radiographic findings. Radiologists studying patients with suprasacral cord lesions should be aware of the causes, symptoms, and treatment of autonomic dysreflexia. Although video urodynamics is the state-of-the-art modality for evaluating complex or refractory neurogenic bladder, the practicing radiologist with an understanding of this condition can detect many radiographic changes in the lower urinary tract that suggest neurogenic dysfunction of various types.

The Physiology of the Internal Urinary Sphincter

No AccessJournal of Urology1 Oct 1970The Physiology of the Internal Urinary Sphincter Francis J. Kleeman Francis J. KleemanFrancis J. Kleeman More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)61779-8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1970 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byRajasekaran M, Sohn D, Salehi M, Bhargava V, Fritsch H and Mittal R (2018) Role of Puborectalis Muscle in the Genesis of Urethral PressureJournal of Urology, VOL. 188, NO. 4, (1382-1388), Online publication date: 1-Oct-2012.RODIC B, CURT A, DIETZ V and SCHURCH B (2018) BLADDER NECK INCOMPETENCE IN PATIENTS WITH SPINAL CORD INJURY: SIGNIFICANCE OF SYMPATHETIC SKIN RESPONSEJournal of Urology, VOL. 163, NO. 4, (1223-1227), Online publication date: 1-Apr-2000.Kobayashi S, Demura T, Nonomura K and Koyanagi T (2018) Autoradiographic Localization of α1-Adrenoceptors in Human Prostate: Special Reference to Zonal DifferenceJournal of Urology, VOL. 146, NO. 3, (887-890), Online publication date: 1-Sep-1991.Bosch R, Aboseif S, Benard F, Stief C, Schmidt R and Tanagho E (2018) Synchronized Electrical Stimulation of the Sympathetic and Parasympathetic Innervation of the Bladder: Facilitation of the Initiation of Micturition in the DogJournal of Urology, VOL. 144, NO. 5, (1252-1257), Online publication date: 1-Nov-1990.Finkbeiner A (2018) Is Bethanechol Chloride Clinically Effective in Promoting Bladder Emptying? A Literature ReviewJournal of Urology, VOL. 134, NO. 3, (443-449), Online publication date: 1-Sep-1985.El-salmy S, Downie J and Awad S (2018) Bladder and Urethral Function and Supersensitivity to Subcutaneously Administered Bethanechol in Cats with Chronic Cauda Equina LesionsJournal of Urology, VOL. 134, NO. 5, (1011-1018), Online publication date: 1-Nov-1985.Gilja I, Radej M, Kovačić M and Parazajder J (2018) Conservative Treatment of Female Stress Incontinence with ImipramineJournal of Urology, VOL. 132, NO. 5, (909-911), Online publication date: 1-Nov-1984.Sogbein S, Downie J and Awad S (2018) Urethral Response During Bladder Contraction Induced by Subcutaneous Bethanechol Chloride: Elicitation of a Sympathetic Reflex Urethral ConstrictionJournal of Urology, VOL. 131, NO. 4, (791-795), Online publication date: 1-Apr-1984.Woodside J (2018) Urodynamic Evaluation of Dysfunctional Bladder Neck Obstruction in MenJournal of Urology, VOL. 124, NO. 5, (673-677), Online publication date: 1-Nov-1980.Benson G, Mcconnell J and Wood J (2018) Adrenergic Innervation of the Human Bladder BodyJournal of Urology, VOL. 122, NO. 2, (189-191), Online publication date: 1-Aug-1979.Fletcher T and Bradley W (2018) Neuroanatomy of the Bladder-UrethraJournal of Urology, VOL. 119, NO. 2, (153-160), Online publication date: 1-Feb-1978.Scott M and Morrow J (2018) Phenoxybenzamine in Neurogenic Bladder Dysfunction After Spinal Cord Injury. 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Defects in regulatory mechanisms of autonomic function in injuries to spinal cord.

ArticlesDEFECTS IN REGULATORY MECHANISMS OF AUTONOMIC FUNCTION IN INJURIES TO SPINAL CORDLewis J. Pollock, Benjamin Boshes, Herman Chor, Isidore Finkelman, Alex J. Arieff, and Meyer BrownLewis J. Pollock, Benjamin Boshes, Herman Chor, Isidore Finkelman, Alex J. Arieff, and Meyer BrownPublished Online:01 Mar 1951https://doi.org/10.1152/jn.1951.14.2.85MoreSectionsPDF (1 MB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat Back to Top Next Download PDF FiguresReferencesRelatedInformation Cited ByHuman temperature regulation under heat stress in health, disease, and injuryMatthew N. Cramer, Daniel Gagnon, Orlando Laitano, and Craig G. Crandall19 August 2022 | Physiological Reviews, Vol. 102, No. 4Cold pressor test in spinal cord injury—revisited20 December 2017 | Spinal Cord, Vol. 56, No. 6Neurogenic Fever after Acute Traumatic Spinal Cord Injury: A Qualitative Systematic Review30 January 2016 | Global Spine Journal, Vol. 6, No. 6Thermoregulatory Considerations for the Performance of Exercise in SCI23 December 2016Severity of autonomic dysfunction in patients with complete spinal cord injury28 July 2011 | Clinical Autonomic Research, Vol. 22, No. 1Local response to cold in rat tail after spinal cord transectionTomas Kalincik, Katarina Jozefcikova, Phil M. E. Waite, and Pascal Carrive1 June 2009 | Journal of Applied Physiology, Vol. 106, No. 6Immunoactivation and Altered Intercellular Communication Mediate the Pathophysiology of Spinal Cord InjuryPharmacotherapy, Vol. 25, No. 2Hypothermia Associated with Autonomic Dysreflexia After Traumatic Spinal Cord InjuryAmerican Journal of Physical Medicine & Rehabilitation, Vol. 81, No. 3Characteristics of Body Heat Balance of Paraplegics during Exercise in a Hot Environment.Journal of PHYSIOLOGICAL ANTHROPOLOGY and Applied Human Science, Vol. 20, No. 4Cardiovascular consequences of loss of supraspinal control of the sympathetic nervous system after spinal cord injuryArchives of Physical Medicine and Rehabilitation, Vol. 81, No. 4Gastric myoelectrical activity in patients with cervical spinal cord injuryAmerican Journal of Gastroenterology, Vol. 93, No. 12Beta blockade in the treatment of autonomic dysreflexia: A case report and reviewArchives of Physical Medicine and Rehabilitation, Vol. 79, No. 5Sympathetic vasoconstrictor reflex pattern in patients with complex regional pain syndromePain, Vol. 75, No. 1Autonomic Dysfunction in Spinal Cord DiseaseThermoregulation in spinal cord injury: the challenge of the Atlanta ParalympicsSpinal Cord, Vol. 34, No. 7Circulating Levels of Soluble Interleukin 2 Receptors Are Elevated in the Sera of Humans with Spinal Cord Injury2 June 2016 | The Journal of The American Paraplegia Society, Vol. 16, No. 1Hyperpyrexia in spinal injury patientsSpinal Cord, Vol. 30, No. 5Thermoregulatory stress during rest and exercise in heat in patients with a spinal cord injuryEuropean Journal of Applied Physiology and Occupational Physiology, Vol. 64, No. 6Autonomic Dysreflexia and its Urological Implications: A ReviewJournal of Urology, Vol. 146, No. 6Spinal mediation of thermally induced sweating.Journal of Neurology, Neurosurgery & Psychiatry, Vol. 54, No. 4Anesthetic Considerations in the Patient with Acute Spinal Cord InjuryCritical Care Clinics, Vol. 3, No. 3Effect of traumatic spinal cord transection on human upper gastrointestinal motility and gastric emptyingGastroenterology, Vol. 87, No. 1Thermoregulatory set point in patients with spinal cord injuries (spinal man)Spinal Cord, Vol. 21, No. 4Percutaneous epidural neurostimulation in modulation of paraplegic spasticityActa Neurochirurgica, Vol. 49, No. 3-4Cardiovascular aspects of autonomic dysreflexia since Guttmann and Whitteridge (1947)Spinal Cord, Vol. 17, No. 1Neurophysiologie und -Pathophysiologie der SchweißsekretionAutonomic Dysreflexia in Spinal Cord InjuryNursing Clinics of North America, Vol. 9, No. 4Physical work capacity and physical conditioning in paraplegic patientsSpinal Cord, Vol. 11, No. 3Experimental hyperthermia in traumatic quadriplegiaInternational Journal of Biometeorology, Vol. 15, No. 2-4Temperature regulation in paraplegiaSpinal Cord, Vol. 9, No. 3Hemodynamic responses to acute quadriplegia with or without chest traumaJournal of Neurosurgery, Vol. 34, No. 2Paraplegia and cardiac arrest: Case reportsCanadian Anaesthetists’ Society Journal, Vol. 17, No. 5Primary neurogenic orthostatic hypotensionJournal of Neurology, Neurosurgery & Psychiatry, Vol. 33, No. 3SYMPATHETIC INNERVATION OF ARTERIAL TREEVasomotor Responses to Cooling in the Extremities of Subjects with Neurologic LesionsCirculation, Vol. 19, No. 4The Management of the Spastic Bladder in ParaplegiaJournal of Urology, Vol. 79, No. 4Vasomotor Responses in the Extremities of Subjects with Various Neurologic LesionsCirculation, Vol. 15, No. 4Studies on the Sacral Reflex ARC in ParaplegiaJournal of Neurosurgery, Vol. 12, No. 5 More from this issue > Volume 14Issue 2March 1951Pages 85-93 https://doi.org/10.1152/jn.1951.14.2.85PubMed14814570History Published online 1 March 1951 Published in print 1 March 1951 Metrics