Context: There are few treatment options for managing
autonomic dysreflexia in patients with chronic
spinal cord injury (SCI). According to some studies, intravesical
botulinum toxin for SCI patients with
autonomic dysreflexia has a preventive effect on symptoms of
autonomic dysreflexia. However, the usefulness of an intravesical
botulinum toxin injection has never been reported for
autonomic dysreflexia in an adult patient with chronic cervical SCI, although there has been for one pediatric patient.Findings: A 62-year-old man with chronic cervical SCI had
neurogenic bladder due to C6-7 SCI since sustaining a fall in 1980. He presented with an intermittent
headache and severe
hypertension because of persistent
autonomic dysreflexia. His symptoms did not improve with
conservative management, and he could not undergo an operation to resect the
lung cancer because of his uncontrolled blood pressure. To control his fluctuating blood pressure, he was taken to an operating room to receive an intravesical
botulinum toxin injection for refractory bladder
spasms. Subsequently, his blood pressure was controlled, and then the lung mass could be surgically removed. His improved condition lasted for more than 6 months.Conclusion: This case suggests that
botulinum toxin is a logical treatment option for
autonomic dysreflexia as well as neurogenic detrusor overactivity in patients with chronic SCI. Dedicated research is warranted to assess the efficacy of an intravesical
botulinum toxin injection, as it was used successfully to stop the symptoms of
autonomic dysreflexia in our patient.