Bateman Anne M, Goldish Gary D
Veteran Affairs Medical Center, Minneapolis, Minnesota 55417, USA.
J Spinal Cord Med. 2002 Spring;25(1):40-2. doi: 10.1080/10790268.2002.11753601.
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.
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.
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.
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.
虽然自主神经反射异常（AD）在脊髓损伤（SCI）人群中已有充分记录，但在多发性硬化症（MS）患者中的发生情况却并非如此。脊髓中第六胸椎水平及以上的密集多发性硬化病变可导致下行抑制冲动中断，从而引发AD。一名MS患者因AD的典型体征和症状前来我们机构就诊。我们认为，对MS患者中这种情况风险的认识不足导致了诊断延误。
病例报告阐述了一名MS患者的AD情况。对为MS患者提供护理的临床医生进行了一项便利调查。该调查考察了对MS患者中AD的认识和经验。
45%的受访者表示他们不知道MS患者存在AD的潜在风险。只有10%的受访者表示他们在临床工作中知晓有MS患者发生过AD。
虽然AD在MS中可能比在SCI中少见，但该病例似乎并非个例。对MS这种潜在的危及生命并发症的认识似乎有限。
