Autonomic dysreflexia in multiple sclerosis

Abstract

Background: Although autonomic dysreflexia (AD) is well documented in the spinal cord injury (SCI) population, its occurrence in persons with multiple sclerosis (MS) is not. A dense multiple sclerotic lesion in the spinal cord at or above the sixth thoracic level can cause interruption of descending inhibitory impulses and thus result in AD. A patient with MS presented to our facility with classic signs and symptoms of AD. We believe that lack of knowledge about the risks for this condition in MS led to a delay in diagnosis.

Methods: Case report illustrates AD in a person with MS. A convenience survey was conducted among clinicians who provide care to people with MS. The survey looked at both awareness of, and experience with, AD in MS.

Results: Forty-five percent of the respondents indicated they were not aware of the potential risk for AD among MS patients. Only 10% indicated they were aware of MS patients in their practice who had experienced AD.

Conclusion: Although AD is probably less common in MS than in SCI, this case does not appear to be unique. Knowledge of this potential life-threatening complication of MS seems to be limited.