Autonomic dysreflexia in multiple sclerosis.

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.