Volume 44 Number 1 2007
Pages 103 — 112
Abstract - Assessment of autonomic dysfunction following spinal cord injury:
Rationale for additions to International Standards for Neurological Assessment
Andrei V. Krassioukov, MD, PhD;1* Ann-Katrin Karlsson, MD, PhD;2 Jill M. Wecht, PhD;3 Lisa-Ann Wuermser, MD;4 Christopher J. Mathias, DPhil, DSc, FRCP, FMedSci;5 Ralph J. Marino, MD, MSCE6
1Department of Physical Medicine and Rehabilitation, International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada; 2Institute of Neuroscience and Physiology, Sahlgrenska Academy,
Gothenburg, Sweden; 3Department of Veterans Affairs (VA) Rehabilitation Research and Development Center of Excellence Spinal Cord Injury and Medical Services, VA Medical Center, Bronx, NY; 4Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago, Chicago, IL; 5Neurovascular Medicine Unit, Faculty of Medicine, Imperial College London, London, UK; and Autonomic Unit, National Hospital for Neurology and Neurosurgery, Institute of Neurology, Queen Square, University College London, London, UK; 6Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, PA
Abstract — We present a preliminary report of the discussion of the joint committee of the American Spinal Injury Association (ASIA) and the International Spinal Cord Society concerning the development of assessment criteria for general autonomic function testing following spinal cord injury (SCI). Elements of this report were presented at the 2005 annual meeting of the ASIA. To improve the evaluation of neurological function in individuals with SCI and therefore better assess the effects of therapeutic interventions in the future, we are proposing a comprehensive set of definitions of general autonomic nervous system dysfunction following SCI that should be assessed by clinicians. Presently the committee recommends the recognition and assessment of the following conditions: neurogenic shock, cardiac dysrhythmias, orthostatic hypotension, autonomic dysreflexia, temperature dysregulation, and hyperhidrosis.
Key words: assessment standards, autonomic dysfunction, autonomic dysreflexia, bradycardia, cardiovascular control, orthostatic hypotension, rehabilitation, spinal cord injury, sweating, temperature.