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. 2017 Dec 29:3:17102.
doi: 10.1038/s41394-017-0018-7. eCollection 2017.

Autonomic dysreflexia caused by cervical stenosis

Krishn Khanna  1 , Alexander A Theologis  1 , Bobby Tay  1
Affiliations

Autonomic dysreflexia caused by cervical stenosis

Krishn Khanna et al. Spinal Cord Ser Cases. .

Abstract

Introduction: Autonomic dysreflexia (AD) is a well-known sequela of high spinal cord injuries (SCI). The characteristic episodic presentation is one of increased sympathetic tone: diaphoresis, hypertension, tachycardia, or reflex bradycardia. The episodes are triggered by visceral sensations and can last days to weeks.

Case presentation: This report presents the case of a 73-year-old male with cervical stenosis, with a longstanding history of "hot flashes" accompanied by dizziness, flushing and diaphoresis, and palpitations. The patient was evaluated extensively by cardiology, endocrinology, and neurology with no treatable pathology determined aside from the patient's cervical stenosis. The patient was diagnosed with autonomic dysreflexia caused by cervical spinal stenosis and underwent anterior cervical decompression and fusion (ACDF) at the stenotic C5-C6 level. He found near complete resolution of his autonomic symptoms.

Discussion: We hypothesize that the cervical compression caused a disruption in the regulatory control of the sympathetic preganglionic neurons resulting in the autonomic symptoms. Although numerous studies exist of patients with a traumatic onset of AD, to the best of our knowledge, this is the first case report in the literature of autonomic symptoms that stemmed from cervical stenosis. The purpose of this case report is to alert clinicians to a potential association between AD and spinal stenosis, which may exist outside the realm of SCI.

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Conflict of interest statement

Compliance with ethical standardsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Initial cervical spine radiographs (a, b, d, e), and MRI (c, f) in 2014 demonstrate multi-level degenerative disc disease with mild/moderate central and bilateral foraminal stenosis at C5-6
Fig. 2
Fig. 2
Follow-up cervical spine lateral radiographs (a) and MRI (b) in 2016 demonstrate progression of multi-level degenerative disc disease with moderate/severe central and bilateral foraminal stenosis at C5-6
Fig. 3
Fig. 3
Immediate post-operative (a) and 3-month follow-up (b, c) radiographs in 2016 after C5-6 anterior cervical discectomy and fusion with structural allograft and anterior plating
See this image and copyright information in PMC

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