Question

Signs and Symptoms of Autonomic dysreflexia are usually seen at what neurological level of spinal cord injury?

• A. T4 and above
• B. T6 and above
• C. T8 and above
• D. T10 and above
• E.

Hint:

Autonomic dysreflexia = Spinal injury at T6 or above + Hypertension + Bradycardia + Sweating above lesion.

Answer 1

The Correct Option is B

Step 1: Understanding autonomic dysreflexia.
Autonomic dysreflexia is a medical emergency that occurs in patients with spinal cord injury.
It is characterized by sudden and severe hypertension, headache, sweating above the lesion, bradycardia, and flushing.
It is triggered by noxious stimuli below the level of injury such as bladder distension, bowel impaction, or skin irritation.
Step 2: Neurological basis.
The sympathetic outflow responsible for vascular tone arises from the thoracolumbar segments of the spinal cord.
Lesions at or above T6 impair descending inhibitory control of sympathetic neurons.
This leads to unchecked sympathetic discharge below the level of injury and results in autonomic dysreflexia.
Step 3: Analysis of options.
- (A) T4 and above: Too high, though lesions at this level also predispose, but T6 is the standard cutoff.
- (B) T6 and above: Correct. Injuries at T6 or above most commonly lead to autonomic dysreflexia.
- (C) T8 and above: Lesions below T6 are less likely to produce severe autonomic dysreflexia.
- (D) T10 and above: Too low, autonomic dysreflexia is very rare in these cases.
Step 4: Clinical importance.
Prompt recognition and treatment are essential, since severe hypertension can cause stroke, seizures, or cardiac arrest.
Treatment includes sitting the patient upright, removing the triggering stimulus, and administering antihypertensives if necessary.
Step 5: Conclusion.
Therefore, autonomic dysreflexia is usually seen in spinal cord injuries at T6 and above.