Autonomic dysreflexia and posterior reversible encephalopathy syndrome

Am J Phys Med Rehabil. 2013 May;92(5):453-8. doi: 10.1097/PHM.0b013e3182744889.


Autonomic dysreflexia is a syndrome of massive imbalanced reflex sympathetic discharge in patients who had a spinal cord injury above the splanchnic sympathetic outflow resulting in a sudden increase in blood pressure. Posterior reversible encephalopathy syndrome (PRES) refers to a clinicoradiologic entity characterized by headache, consciousness impairment, visual disturbances, seizures, and posterior transient changes on neuroimaging (cerebral vasogenic edema). Hypertension is a common cause of PRES. The authors describe two case reports of patients with tetraplegia who developed PRES after an autonomic dysreflexia episode. One of them had recurrence of PRES in a similar clinical context. The authors discuss further aspects of PRES and its recurrence, which seems to be unusual particularly after autonomic dysreflexia.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Accidents, Traffic
  • Adult
  • Autonomic Dysreflexia / diagnosis
  • Autonomic Dysreflexia / etiology*
  • Autonomic Dysreflexia / therapy
  • Combined Modality Therapy
  • Follow-Up Studies
  • Humans
  • Injury Severity Score
  • Magnetic Resonance Angiography / methods
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Posterior Leukoencephalopathy Syndrome / diagnosis
  • Posterior Leukoencephalopathy Syndrome / etiology*
  • Posterior Leukoencephalopathy Syndrome / therapy
  • Quadriplegia / complications*
  • Quadriplegia / diagnosis
  • Quadriplegia / rehabilitation
  • Recurrence
  • Risk Assessment
  • Spinal Cord Injuries / complications*
  • Spinal Cord Injuries / diagnosis
  • Spinal Cord Injuries / rehabilitation
  • Treatment Outcome