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To the Editor.—
In QUESTIONS AND ANSWERS (228:625, 1974) concerning vasomotor-like paroxysms, a reply is given by Dr. D. J. Breslin of the Lahey Clinic. I would like to add my comments.The symptoms of flushed face, tachycardia, sudden elevations of blood pressure, chest pain, and violent shaking of the body described in a 67-year-old woman for 30 years following a cerebral embolism are observed very often in spinal cord injury patients with high cord involvement. These symptoms are considered to be mass sympathetic release—sympathetic hyperreflexia. Because the damping function of the brain is interrupted by the cord transection, the sympathetic reaction to any stimulation from the bladder or sphincter ani is uninhibited. It is possible that in the patient described, the cerebral embolism has caused a lessening of the damping capacity of her brain, and thus cannot control sympathetic reactions arising from her bladder or anal area. Any distension
Scheinberg D. Vasomotor-like Paroxysms. JAMA. 1974;229(2):140–141. doi:10.1001/jama.1974.03230400016016
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