N. B. KURNICK, M.D.
Somatic hyperreflexia following interruption by spinal cord lesions of inhibitory impulses from higher centers is well known. There is, perhaps, less awareness of the analogous autonomic hyperreflexia.1-6 Since the major splanchnic outflow in this system is from the T4 or T6 to L2 segments of the cord, dramatic dysfunction of the autonomic system is seen primarily following lesions above this level, i.e., high thoracic and cervical cord lesions. At least 85% of quadriplegic patients develop autonomic hyperreflexia characterized by paroxysmal hypertension (Bors, personal communication).
A diagrammatic sketch of the tracts concerned is shown in figure 1. Afferent pathways are
KURNICK NB. AUTONOMIC HYPERREFLEXIA AND ITS CONTROL IN PATIENTS WITH SPINAL CORD LESIONS(AUTONOMIC HYPERREFLEXIA AND ITS CONTROL IN PATIENTS WITH SPINAL CORD LESIONS*). Ann Intern Med. 1956;44:678–686. doi: 10.7326/0003-4819-44-4-678
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Published: Ann Intern Med. 1956;44(4):678-686.
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