Hyperreflexia

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Hyperreflexia
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Exaggerated reflex responses
Complications	Autonomic dysreflexia, muscle spasticity
Onset	Sudden or gradual
Duration	Variable
Types	N/A
Causes	Spinal cord injury, multiple sclerosis, cerebral palsy, stroke
Risks	Spinal cord injury, neurological disorders
Diagnosis	Clinical examination, neurological examination
Differential diagnosis	Hyporeflexia, normal reflexes
Prevention	N/A
Treatment	Physical therapy, medication
Medication	Muscle relaxants, antispastic agents
Prognosis	Depends on underlying cause
Frequency	Common in individuals with spinal cord injury
Deaths	N/A

Hyperreflexia is a condition characterized by an overreaction of the autonomic nervous system to stimuli. It is most commonly observed in individuals who have suffered a spinal cord injury at or above the T5 level. Hyperreflexia can lead to various symptoms, ranging from mild to potentially life-threatening conditions such as autonomic dysreflexia.

Causes

Hyperreflexia primarily occurs in response to a disturbance in the balance between the sympathetic and parasympathetic divisions of the autonomic nervous system, often as a result of:

• Spinal cord injury, particularly at the T5 level or above
• Other neurological disorders that affect the spinal cord or brain

Pathophysiology

The pathophysiology of hyperreflexia involves an exaggerated response of the nervous system to stimuli, due to a disruption in the neural pathways that normally modulate reflexes. After a spinal cord injury, the normal flow of nerve signals is interrupted, leading to a loss of inhibitory control over reflex actions.

An overview of the autonomic nervous system and its components.

Symptoms

Symptoms of hyperreflexia may include:

• Increased muscle tone or spasms
• Exaggerated reflex responses
• Sweating and skin flushing above the level of injury
• Sudden high blood pressure (in cases of autonomic dysreflexia)

Diagnosis

Diagnosis of hyperreflexia involves a clinical assessment by a healthcare professional, including a detailed medical history and a physical examination. Neurological tests to evaluate reflexes and autonomic function may also be conducted.

Treatment

Treatment for hyperreflexia focuses on managing symptoms and preventing complications. Strategies may include:

• Medications to control blood pressure and muscle spasms
• Regular monitoring for signs of autonomic dysreflexia
• Education for patients and caregivers on potential triggers and emergency management

Implications for Care

Individuals with hyperreflexia, especially those with spinal cord injuries, require comprehensive care plans to manage symptoms and prevent complications. Healthcare providers should educate patients and caregivers on recognizing symptoms of autonomic dysreflexia, a potentially life-threatening condition associated with hyperreflexia.

See Also

• Spinal cord injury
• Autonomic dysreflexia
• Autonomic nervous system

References

• "Spinal Cord Medicine: Principles and Practice." Lin, V.W.; Cardenas, D.D.; Cutter, N.C.; et al., Editors. Demos Medical Publishing, 2010.
• "Management of Autonomic Dysreflexia: Current Best Practices." Journal of Spinal Cord Medicine, 2017.

External Links

• National Institute of Neurological Disorders and Stroke (NINDS)
• Christopher & Dana Reeve Foundation

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