Hesperian Health Guides
Dysreflexia (Sudden High Blood Pressure with Pounding Headaches)
HealthWiki > Disabled Village Children > Chapter 23: Spinal Cord Injury > Dysreflexia (Sudden High Blood Pressure with Pounding Headaches)
Dysreflexia is the body’s reaction to something that would normally cause pain or irritation, but which the person does not feel because of the spinal cord injury.
COMMON CAUSES OF DYSREFLEXIA
- bladder problems—especially when the bladder is too full, infected, or has bladder stones (This is by far the most common cause.)
- stretching of the bowel—from constipation, with a big ball of hard shit, or from finger pressure to remove the shit
- pressure areas or sores—or even irritation from lying on a small object without knowing it
- burns
- spasm of the womb—especially just before or in the first days of a woman’s monthly period, or during childbirth
SIGNS (OF DYSREFLEXIA)
- severe pounding headache
- sweating of the head
- stuffy nose
- reddish skin patches on face and neck
- goose pimples above the level of injury
- slow pulse
- high blood pressure (up to 240/150)
Dysreflexia is a medical emergency. The high blood pressure could cause seizures or deadly bleeding inside the brain.
What to do
Act quickly to remove the cause and lower the blood pressure.
| 1. Quickly lower the blood pressure in the head. ♦ If lying, sit up; stay sitting until the signs go away.
♦ Change position, drop feet down, loosen belt or straps, remove tight stockings. |
| 2. Look for the cause of dysreflexia, and remove it if possible.
♦ Bladder. Feel the lower belly to see if the bladder is full. If a catheter is in place, check for bends or kinks and straighten them to let urine flow. If the catheter is stopped up, open it by injecting the catheter with 10 cc. sterile saline solution or water that has been boiled and cooled to body temperature. Or take the catheter out. If a catheter is not in place and the person cannot pee, put in a catheter and empty the bladder (see "How to Put in a Catheter").
♦ If a urinary infection appears to be the cause, inject an anesthetic solution into the bladder through a catheter. Use 10 cc. 1% lidocaine in 20 cc. of boiled water. Clamp the catheter for 20 minutes and then release. Treat the infection.
♦ Bowel. If the bladder does not seem to be the cause, check for a full bowel. How long has it been since the last bowel movement (shit)? Put some lidocaine (Xylocaine) jelly on your finger and check if the bowel is packed with hard shit. If it is, wait 2 minutes for sensation in the area to decrease. Then put more lidocaine jelly on your finger and gently remove the shit. If the headache becomes worse while you're doing this, stop and put in more lidocaine jelly. Wait 20 minutes and try again to gently remove the shit with your finger.
♦ Pressure. Change the child’s position in order to relieve pressure over bony areas. (Sometimes just staying in the same position too long can bring on dysreflexia.) |
| 3. If the signs do not go away, get medical help as fast as possible. |
| 4. If the child has frequent or severe periods of dysreflexia, or you cannot find the cause, try to have him seen by a specialist on spinal cord injury, and possibly a ‘urologist’ (specialist of the urine system). |
Suggestion: In villages where community members have quadriplegia, it is wise to have injectable 1% lidocaine (Xylocaine) and lidocaine gel available for dysreflexia emergencies.
This page was updated:25 Nov 2024