Autonomic hyper-reflexia modulated by percutaneous epidural neurostimulation: a preliminary report.
Our clinical experience in the management of five paraplegic or quadriplegic patients with subjective complaints and objective findings of autonomic hyper-reflexia is presented. These five patients had epidural neurostimulation systems implanted percutaneously to regulate intractable spasticity. During a follow-up period varying from 2 months to almost 2 years, four of the five patients experienced no episodes of autonomic dysfunction with the use of a low frequency, low voltage, square wave pulse output. From their responses and from recent neurophysiological evidence, the potential benefit of percutaneous epidural neurostimulation in the modulation of autonomic hyper-reflexia without antihypertensive medication is suggested. Further follow-up of these patients and additional clinical research should be performed to confirm our initial clinical impressions.
D000293:Adolescent; D000328:Adult; D001341:Autonomic Nervous System; D004599:Electric Stimulation Therapy; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D008297:Male; D009128:Muscle Spasticity / Q000628:therapy*; D010264:Paraplegia / Q000628:therapy; D011782:Quadriplegia / Q000628:therapy; D012021:Reflex, Abnormal / Q000628:therapy*; D013116:Spinal Cord; D013577:Syndrome