Toxins, 2023 · DOI: 10.3390/toxins15020108 · Published: January 26, 2023
Spinal cord injuries can disrupt the autonomic nervous system, leading to autonomic dysreflexia (AD), especially in injuries above T6. AD can cause dangerously high blood pressure due to unregulated sympathetic reflexes triggered by stimuli like bladder sensations. Botulinum toxin A (Botox) injections are commonly used for neurogenic detrusor overactivity. This study explores Botox's role in managing AD by injecting it into either the detrusor muscle or the urethral sphincter. The study found that both detrusor and urethral sphincter injections improved AD symptoms. Detrusor injections appeared more effective, likely due to reduced bladder pressure and increased compliance.
Consider detrusor Botox injections for SCI patients with AD, especially those with poor bladder compliance and high detrusor pressure.
Additional detrusor injections may be beneficial for patients initially indicated for urethral injections but still experiencing AD symptoms.
Further research is needed to develop objective evaluation tools for AD severity and to conduct randomized controlled trials to confirm these findings.