Medical emergency: rash, headache and spinal cord injury.
BMJ Case Rep
; 14(4)2021 Apr 07.
Article
in En
| MEDLINE
| ID: mdl-33827865
ABSTRACT
A 49-year-old consultant medical oncologist, with a medical history of complete T5 spinal cord injury (March 1992) and long-term paralysis from the chest down, presented with shingles affecting the T7 dermatome. He also had a dull frontal headache, a feeling of agitation and increased blood pressure of 135/90 on a home blood pressure machine (higher than his usual blood pressure of 90/70). Having been taught about autonomic dysreflexia at the time of his initial spinal cord injury, he self-diagnosed autonomic dysreflexia caused by the noxious stimulus of shingles below his level of spinal cord injury. He self-administered a nifedipine 5 mg sublingual capsule to decrease his blood pressure before urgently seeing his general practitioner. Treatment of the shingles with acyclovir and analgesia successfully managed the problem and avoided hospital admission. This case highlights key aspects in treating autonomic dysreflexia and the value of doctor-patient partnership in doing so.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Autonomic Nervous System Diseases
/
Spinal Cord Injuries
/
Autonomic Dysreflexia
/
Exanthema
Type of study:
Diagnostic_studies
/
Etiology_studies
Limits:
Humans
/
Male
/
Middle aged
Language:
En
Journal:
BMJ Case Rep
Year:
2021
Document type:
Article
Affiliation country:
Reino Unido