Which of the following is a sign/symptom of autonomic dysreflexia?

• A. Pounding headache, flushing, nasal congestion, nausea, anxiety, prickling sensation in skull, sweating
• B. Hypotension
• C. Rash with fever
• D. Shortness of breath only

Answer: (A)

Autonomic dysreflexia presents as a sudden, dangerous surge of the sympathetic nervous system in people with spinal cord injury above the level of T6. A triggering noxious stimulus below the injury (like a full bladder or bowel impaction) causes an unopposed reflex that drives severe hypertension and a cluster of autonomic symptoms. The most characteristic signs include a pounding headache from the high blood pressure, flushing or skin warmth above the level of injury, nasal congestion, nausea, anxiety, and a prickling or tingling sensation in the head, along with sweating. These symptoms reflect both the spike in blood pressure and the body’s disrupted autonomic regulation.

The other options don’t fit because autonomic dysreflexia is not about low blood pressure, a fever-related rash, or symptoms limited to shortness of breath. When this pattern is seen, it’s a medical emergency requiring prompt identification and removal of the triggering stimulus, and measures to safely lower the blood pressure, such as positioning the patient upright and checking for common triggers like a full bladder or bowel impaction.