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Peer-reviewedCC BYSpinal cord series and cases

Surgery to treat autonomic dysreflexia due to cubital tunnel syndrome in cervical spinal cord injury: a case report.

  • Kevin He1
  • Brian Chin1
  • Jonah P Orr1
  • Lucas Rohrer1
  • Ida K Fox2
  1. 1Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, St. Louis, Missouri, USA.
  2. 2Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, St. Louis, Missouri, USA. [email protected].
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Abstract

Introduction

Autonomic dysreflexia (AD) is a potentially fatal syndrome in people with spinal cord injury (SCI) marked by episodic hypertension with flushing, diaphoresis, and bradycardia. Common etiologies include bladder distension and bowel impaction. Compressive neuropathies lack attention as a potential precipitant of AD. This report describes an individual with cervical SCI and with recurrent AD treated with ulnar nerve decompression surgery.Case presentation

A 74-year-old woman with a remote history of C6 SCI (American Spinal Injury Association Impairment Scale Grade B) presented to clinic with recurrent episodes of AD that had been refractory to standard treatment measures. History and clinical examination were suggestive of ulnar nerve compressive neuropathy at the elbow - cubital tunnel syndrome. The diagnosis was confirmed with electrodiagnostic studies and neuromuscular ultrasound. Treatment with surgery successfully resolved her episodes of AD.Discussion

This case identifies compressive neuropathy as a treatable cause of AD in individuals with cervical SCI. When more common etiologies of AD are excluded, clinicians should consider compressive peripheral neuropathies as potential causes of AD. Surgical decompression may alleviate symptoms of AD in select cases. Further research should investigate the prevalence and optimal management of compressive neuropathy in people with SCI.

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Cite

BibTeXRIS
BibTeX
@article{he2026surgery,
  title = {{Surgery to treat autonomic dysreflexia due to cubital tunnel syndrome in cervical spinal cord injury: a case report.}},
  author = {Kevin He and Brian Chin and Jonah P Orr and Lucas Rohrer and Ida K Fox},
  journal = {Spinal cord series and cases},
  year = {2026},
  month = oct,
  doi = {10.1038/s41394-026-00750-4},
  url = {https://europepmc.org/article/MED/42875417},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Surgery to treat autonomic dysreflexia due to cubital tunnel syndrome in cervical spinal cord injury: a case report.
AU  - Kevin He
AU  - Brian Chin
AU  - Jonah P Orr
AU  - Lucas Rohrer
AU  - Ida K Fox
PY  - 2026
DA  - 2026/10/14
JO  - Spinal cord series and cases
DO  - 10.1038/s41394-026-00750-4
UR  - https://europepmc.org/article/MED/42875417
AB  - Introduction  Autonomic dysreflexia (AD) is a potentially fatal syndrome in people with spinal cord injury (SCI) marked by episodic hypertension with flushing, diaphoresis, and bradycardia. Common etiologies include bladder distension and bowel impaction. Compressive neuropathies lack attention as a potential precipitant of AD. This report describes an individual with cervical SCI and with recurrent AD treated with ulnar nerve decompression surgery.Case presentation  A 74-year-old woman with a remote history of C6 SCI (American Spinal Injury Association Impairment Scale Grade B) presented to clinic with recurrent episodes of AD that had been refractory to standard treatment measures. History and clinical examination were suggestive of ulnar nerve compressive neuropathy at the elbow - cubital tunnel syndrome. The diagnosis was confirmed with electrodiagnostic studies and neuromuscular ultrasound. Treatment with surgery successfully resolved her episodes of AD.Discussion  This case identifies compressive neuropathy as a treatable cause of AD in individuals with cervical SCI. When more common etiologies of AD are excluded, clinicians should consider compressive peripheral neuropathies as potential causes of AD. Surgical decompression may alleviate symptoms of AD in select cases. Further research should investigate the prevalence and optimal management of compressive neuropathy in people with SCI.
SN  - 2058-6124
ER  -