[Clinical studies of autonomic hyperreflexia].

Autonomic hyperreflexia in 25 patients with spinal cord injury has been clinically analyzed. Nineteen of the patients (76%) suffered from neurogenic lesions above Th-5 and the rest (24%) below Th-6. The most frequent subjective symptom was sweating (22 patients), followed by headache, nausea and so forth. These symptoms were encountered mostly in patients with poor voiding efficiency and developed less than one year after the spinal cord injury. Both systolic and diastolic blood pressure elevated with the distension of the bladder. At the maximum bladder capacity both systolic and diastolic pressure were 39% higher than that observed in the empty bladder. Regitin, 10 mg, given intravenously suppressed this elevation by two-thirds compared to the control. The treatment modality consisted of clean intermittent catheterization and external sphincterotomy, to prevent the over-stretching of the detrusor muscle, together with administration of alpha-adrenergic blockers and ganglionic blocking agent, which interrupt the efferent impulse. Twenty two of the patients (88%) were successfully controlled.