Autonomic dysreflexia in a man with multiple sclerosis.

BACKGROUND/

OBJECTIVE

To report manifestation of autonomic dysreflexia (AD) in a man with multiple sclerosis (MS).

DESIGN

Case report.

FINDINGS: A young man presented with a history of several admissions to the emergency department with complaints of hypertensive attacks, palpitations, difficulty in breathing, headaches, and flushing. The attacks were attributed to a previously diagnosed anxiety disorder. Onset of numbness of the left leg numbness prompted a more thorough study, which showed evidence of MS. AD was suspected as the cause of his recurrent attacks of hypertension. Bladder distension was identified as the cause of AD, and his hypertensive attacks were controlled by management of neurogenic bladder.

CONCLUSIONS

This report emphasizes that AD can occur in MS. Somatic symptoms warrant thorough investigation before attributing them to psychosomatic causes.