Autonomic dysreflexia-induced reversible posterior leukoencephalopathy syndrome in patients with spinal cord injury: Two case reports

The Journal of Spinal Cord Medicine, 2013 · DOI: 10.1179/2045772312Y.0000000075 · Published: January 1, 2013

Simple Explanation

Reversible posterior leukoencephalopathy syndrome (RPLS) is a condition identified by MRI showing lesions mainly in the back of the brain. Common symptoms include headaches, seizures, vision problems, and changes in alertness. Autonomic dysreflexia (AD) happens in people with spinal cord injuries at T6 or higher. It's caused by uncontrolled sympathetic nervous system activity, leading to high blood pressure. This report describes two cases where patients with tetraplegia developed RPLS due to AD, which was caused by bladder overdistension.

Study Duration

Not specified

Participants

Two men with spastic tetraplegia

Evidence Level

Case report

Key Findings

1
RPLS can occur in patients with traumatic cervical cord injury due to autonomic dysreflexia.
2
Prompt recognition and treatment of RPLS are crucial to prevent further complications and death in patients with spinal cord injury.
3
In both cases, the autonomic dysreflexia was triggered by bladder distension, leading to hypertension and subsequent RPLS.

Research Summary

This report details two cases of patients with spinal cord injuries who developed reversible posterior leukoencephalopathy syndrome (RPLS) as a result of autonomic dysreflexia (AD). The AD was triggered by bladder overdistension. In both cases, the patients experienced symptoms such as headache, altered mental status, and seizures, along with significant elevations in blood pressure. MRI scans confirmed the presence of RPLS. Treatment involved managing the blood pressure with antihypertensive medications and addressing the underlying cause of AD, such as bladder distension. With prompt intervention, the RPLS was reversible, and the patients' neurological status improved.

Practical Implications

Clinical Awareness

Clinicians should be aware of RPLS as a potential complication of autonomic dysreflexia in patients with spinal cord injury.

Prompt Management

Early recognition and treatment of autonomic dysreflexia, including blood pressure control and addressing the underlying cause, are critical to prevent RPLS.

Bladder Management

Careful bladder management is essential in patients with spinal cord injury to prevent bladder distension and subsequent autonomic dysreflexia.

Autonomic dysreflexia-induced reversible posterior leukoencephalopathy syndrome in patients with spinal cord injury: Two case reports

Simple Explanation

Key Findings

Research Summary

Practical Implications

Clinical Awareness

Prompt Management

Bladder Management

Study Limitations

Your Feedback

Was this summary helpful?

Autonomic dysreflexia-induced reversible posterior leukoencephalopathy syndrome in patients with spinal cord injury: Two case reports

Simple Explanation

Key Findings

Research Summary

Practical Implications

Clinical Awareness

Prompt Management

Bladder Management

Study Limitations

Your Feedback

Was this summary helpful?