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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\u2013patient partnership in doing so.<\/jats:p>","DOI":"10.1136\/bcr-2020-238285","type":"journal-article","created":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T13:29:19Z","timestamp":1617802159000},"page":"e238285","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Medical emergency: rash, headache and spinal cord injury"],"prefix":"10.1136","volume":"14","author":[{"given":"Tom","family":"Wells","sequence":"first","affiliation":[{"name":"Oncology Department, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,4,7]]},"reference":[{"key":"2025082800365459000_14.4.e238285.1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2004.024463"},{"key":"2025082800365459000_14.4.e238285.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m3596"},{"key":"2025082800365459000_14.4.e238285.3","first-page":"1","article-title":"Prevalence of autonomic dysreflexia in patients with spinal cord injury above T6","volume":"2017","author":"Lee","year":"2017","journal-title":"Biomed Res Int"},{"key":"2025082800365459000_14.4.e238285.4","first-page":"275","article-title":"Vascular dysfunctions following spinal cord injury","volume":"3","author":"Popa","year":"2010","journal-title":"J Med Life"},{"key":"2025082800365459000_14.4.e238285.5","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1080\/10790268.2002.11753601","article-title":"Autonomic dysreflexia in multiple sclerosis","volume":"25","author":"Bateman","year":"2002","journal-title":"J Spinal Cord Med"},{"key":"2025082800365459000_14.4.e238285.6","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1080\/10790268.2009.11760772","article-title":"Autonomic dysreflexia in a man with multiple sclerosis","volume":"32","author":"Kulcu","year":"2009","journal-title":"J Spinal Cord Med"},{"key":"2025082800365459000_14.4.e238285.7","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1212\/CON.0000000000000811","article-title":"Autonomic hyperactivity","volume":"26","author":"Rabinstein","year":"2020","journal-title":"Continuum"},{"key":"2025082800365459000_14.4.e238285.8","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31822afff1"},{"key":"2025082800365459000_14.4.e238285.9","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1097\/00007611-197308000-00006","article-title":"Autonomic hyperreflexia in spinal cord injury","volume":"66","author":"Shea","year":"1973","journal-title":"South Med J"},{"key":"2025082800365459000_14.4.e238285.10","doi-asserted-by":"publisher","DOI":"10.1038\/sc.1980.51"},{"key":"2025082800365459000_14.4.e238285.11","first-page":"1","article-title":"Autonomic dysreflexia in traumatic myelopathy","volume":"59","author":"Kewalramani","year":"1980","journal-title":"Am J Phys Med"},{"key":"2025082800365459000_14.4.e238285.12","unstructured":"Allen KJ , Leslie SW . 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