Using the autonomic standards to assess orthostatic hypotension in persons with SCI: a case series

Spinal Cord Series and Cases, 2017 · DOI: https://doi.org/10.1038/s41394-017-0021-z · Published: October 10, 2017

Spinal Cord Injury Cardiovascular Science Neurology

Simple Explanation

Spinal cord injury can disrupt both physical and autonomic functions, leading to blood pressure issues. Orthostatic hypotension, a drop in blood pressure upon standing, can significantly affect daily activities. The International Standards for the Assessment of Autonomic Function after SCI (ISAFSCI) helps doctors assess blood pressure and orthostatic hypotension in SCI patients. This study presents four cases illustrating how medication, bladder management, spasticity, and Valsalva maneuvers can influence orthostatic hypotension in individuals with SCI.

Study Duration

Not specified

Participants

4 case reports of individuals with SCI

Evidence Level

Level 4; Case Series

Key Findings

1
Case 1 showed antidepressants for neuropathic pain can adversely influence orthostatic hypotension.
2
Case 2 described that bladder management affects cardiovascular instability, causing autonomic dysreflexia and subsequent orthostatic hypotension.
3
Case 3 showed an association between spasticity and orthostatic hypotension, with antispasticity medication exacerbating OH.

Research Summary

Impaired blood pressure control in SCI patients can result from medical issues and autonomic dysfunction. Management strategies for orthostatic hypotension vary based on the stage of SCI, its root cause, and other medical conditions. Non-pharmacological treatment is recommended as a first-line intervention, along with the cessation of medications that may contribute to OH.

Practical Implications

Systematic Assessment

Clinicians should systematically use ISAFSCI to document BP irregularities and treatment effects.

Individualized Treatment

Management strategies must be tailored to the individual patient, considering the stage of SCI, symptoms, and medical conditions.

Prioritize Non-Pharmacological Interventions

Non-pharmacological approaches should be the first line of treatment, with careful consideration of medication cessation.

Using the autonomic standards to assess orthostatic hypotension in persons with SCI: a case series

Simple Explanation

Key Findings

Research Summary

Practical Implications

Systematic Assessment

Individualized Treatment

Prioritize Non-Pharmacological Interventions

Study Limitations

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Was this summary helpful?

Using the autonomic standards to assess orthostatic hypotension in persons with SCI: a case series

Simple Explanation

Key Findings

Research Summary

Practical Implications

Systematic Assessment

Individualized Treatment

Prioritize Non-Pharmacological Interventions

Study Limitations

Your Feedback

Was this summary helpful?