Surgery to treat autonomic dysreflexia due to cubital tunnel syndrome in cervical spinal cord injury: a case report.
Kevin He, Brian Chin, Jonah P Orr et al.
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Case in brief
A 74-year-old woman with remote C6 spinal cord injury (AIS B) developed recurrent autonomic dysreflexia episodes that had not responded to standard measures. Her history and examination suggested ulnar nerve compression at the elbow, and electrodiagnostic testing and neuromuscular ultrasound confirmed cubital tunnel syndrome. Ulnar nerve decompression surgery resolved the episodes. The report highlights a peripheral nerve compression as a potential trigger when more common causes of autonomic dysreflexia have been excluded.
What made this case unusual
Cubital tunnel syndrome was identified as a potential precipitant of recurrent autonomic dysreflexia in a person with cervical spinal cord injury, and decompression resolved the episodes.
Diagnostic / clinical pearl
After excluding common triggers of autonomic dysreflexia in cervical spinal cord injury, consider compressive peripheral neuropathy; electrodiagnostic studies and neuromuscular ultrasound can help confirm the diagnosis.
Why it matters
The case suggests that identifying a peripheral nerve compression may reveal a treatable contributor to autonomic dysreflexia in selected patients.