Abdominal Pain & Hypotension & Spasticity - Hyperreflexia: Causes & Reasons

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Patient File

Sex unknown, Age unknown

Reported Symptoms

Abdominal Pain, Hypotension, Spasticity - Hyperreflexia,

Negated

None

Unsure

None

Possible Causes

Scorpion Sting

There was a right facial nerve palsy (upper motor neuron type); right spastic hemiplegia with hyperreflexia and extensor plantar response. Fundoscopy was unremarkable. [atmph.org]

Chronic relapsing pancreatitis is a rare cause of abdominal pain in children and exceptionally rarely is related to a scorpion sting. [ncbi.nlm.nih.gov]

Myocarditis with Hypotension after a Scorpion Sting Maneesha Erraboina 1, Bucchi Reddy 2, Mamatha Reddy 3, Suresh Bandari 1 Department of 1 Pharmacy Practice, Rohini Superspeciality [casereports.in]

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Aromatic L-Amino Acid Decarboxylase Deficiency

[…] clinical features suggesting spasticity. [jn.nutrition.org]

[…] aromatic L-amino acid decarboxylase deficiency who developed serious cardiac rhythm disturbances during treatment with intravenous dopamine and norepinephrine for severe hypotension [ncbi.nlm.nih.gov]

[…] defect in alpha-adrenergic activity is thought to play a key pathological role. 6 7 The autonomic features present in our patient (bilateral ptosis, and protracted periods of hypotension [hkmj.org]

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Pyelonephritis

Symptoms and Signs Cord compression commonly causes gradual spastic paresis, paresthesias, or both in the hands and feet and may cause hyperreflexia. [msdmanuals.com]

Here, we describe a 12-year-old boy who presented with abdominal pain. He did not have any history of urinary tract infection. [ncbi.nlm.nih.gov]

Severe complicated cases can lead to septicaemia, hypotension and shock if left untreated. [symptoma.com]

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Hyponatremia

They are primarily central nervous system (CNS) manifestations, such as irritability, restlessness, lethargy, muscular twitching, spasticity and hyperreflexia, all of which [aafp.org]

Abdominal radiograph showed moderate constipation but her abdominal pain continued even after bowel cleanout. [ncbi.nlm.nih.gov]

After several weeks of suffering from gastroenteritis with vomiting, she presented with disturbance of consciousness, hypotension, dehydration, and severe hyponatremia (108 [ncbi.nlm.nih.gov]

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Anterior Spinal Artery Syndrome

At first the lower limb paralysis was flaccid and areflexic but after several weeks spasticity, hyperreflexia, and Babinski signs appeared. [lksom.temple.edu]

pain. [anesthesiology.pubs.asahq.org]

It is characterized by a corresponding loss of motor function, loss of pain and temperature sensation, and hypotension. [en.wikipedia.org]

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Purpura

Symptoms and Signs Cord compression commonly causes gradual spastic paresis, paresthesias, or both in the hands and feet and may cause hyperreflexia. [msdmanuals.com]

A 7-year-old girl was admitted to the hospital with abdominal pain, vomiting, and fever. [ncbi.nlm.nih.gov]

Potentially serious side-effects include postural hypotension; circulatory collapse; sodium, potassium, and chloride depletion; temporary aggravation of hyperuricemia; and [jamanetwork.com]

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Phenothiazine Poisoning

[…] occur with more frequency in patients in a toxic condition and in dehydrated and febrile patients.3 There is little mention in the literature of reactions which produce spasticity [jamanetwork.com]

Tell your doctor right away if any of these rare but serioussigns of liver problems (such as yellowing eyes /skin, persistent nausea, vomiting, stomach / abdominal pain ), [webmd.com]

[…] other arrhythmia, hypotension and even shock. [healthfrom.com]

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Shy Drager Syndrome

hyperreflexia, and Babinski sign), cognitive impairment, visual hallucinations, and REM sleep behavior disorder (RBD). [doi.org]

Pain and Bloody Stools Complications of Unsafe and Self-Managed Abortion Challenge Yourself Interactive Medical Cases Image Challenge Videos in Clinical Medicine View all [nejm.org]

We suggest that vasopressin may be the drug of choice in patients with Shy-Drager syndrome with refractory hypotension. [ncbi.nlm.nih.gov]

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Churg-Strauss Syndrome

Examination showed spasticity and marked hyperreflexia along with presence of clonus in lower limbs. [n.neurology.org]

A 66-year-old Japanese male presented with a history of recurrent abdominal pain. [ncbi.nlm.nih.gov]

Hypersensitivity reactions, including anaphylaxis, angioedema, bronchospasm, hypotension, urticaria, rash, have occurred. [fda.gov]

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Bone Marrow Metastasis

Spinal cord compression at the level of the cervical or thoracic spine can cause hyperreflexia and spasticity with complete paraplegia. [ncbi.nlm.nih.gov]

Case 2: Clinical history A 48 year-old white woman presented with a four-week history of left lower quadrant abdominal pain. [bmcclinpathol.biomedcentral.com]

Call your doctor or go to your nearest emergency room right away if you have any symptoms of a serious allergic reaction, including low blood pressure (hypotension); trouble [xgeva.com]

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Ovarian Adenoma

The severe spasticity, hyperreflexia, extensor plantar responses and the nature of the abnormal movements make both diagnoses unlikely. [slideheaven.com]

Their patient had a one-year history of gradual abdominal swelling, which was accompanied by constipation and vague abdominal pain. [jmrh.mums.ac.ir]

[…] intraoperative complications are reported in previous studies like splanchnic dilatation and venous pooling after the sudden removal of large intra-abdominal masses, and hypotension [hindawi.com]

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HIV Infection

Symptoms of myelopathy include weakness and sensory changes; upper motor neuron signs, such as spasticity and hyperreflexia, may also be found. Enlarge Print Table 3. [aafp.org]

Symptoms are fever, weight loss, hepatosplenomegaly, malaise, and abdominal pain. [journalofethics.ama-assn.org]

In the emergency department, the patient appeared acutely ill, was febrile, tachycardic, hypotensive, and slow to respond to commands. [pediatrics.aappublications.org]

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Payr's Syndrome

They have global developmental delays in childhood, and they display spasticity and hyperreflexia as adults. [thyroid.org]

Research of Payr's Syndrome has been linked to Colonic Diseases, Aerophagy, Functional Diarrhea, Stasis, Abdominal Pain. [novusbio.com]

Angiotensin II (ANG II) is directly vasoconstrictive, increasing systemic and renal arteriolar constriction, which helps to prevent systemic hypotension. [emedicine.medscape.com]

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Spinal Cord Infarction

Initially areflexia is present due to spinal shock but, hyperreflexia and spasticity appear later The most common form is anterior spinal artery syndrome. [sci-recovery.org]

The presence of concomitant chest or abdominal pain, limb ischemia, or loss of peripheral pulses suggests a possible aortic dissection. [aibolita.com]

To reduce the risk of hypotensive sequelae such as spinal cord infarction, blood pressure should be closely monitored in elderly patients presenting with retrosternal chest [ncbi.nlm.nih.gov]

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Proximal Myopathy with Extrapyramidal Signs

The essential clinical findings are slowly progressive and often include severe spasticity, hyperreflexia, and weakness in a pyramidal distribution, noticeably in both lower [emedicine.medscape.com]

Pain The association of functional abdominal pain and autonomic dysfunction in children is still poorly understood. [pediatrics.aappublications.org]

Dizziness or significant hypotension after treatment with the injection is a rare occurrence. [mentalhealth.com]

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Spinal Shock

PHASE 4- SPASTICITY/HYPERREFLEXIA (1-12 MONTHS) CLINICAL DESCRIPTION-  DPR disappear in majority cases.  Cutaneous reflexes, DTRs and Babinski sign become hyperactive and [slideshare.net]

pain, incontinence, rectal bleeding, hemorrhoids, and autonomic dysreflexia during bowel movements occur in 27% to 62% of individuals with a spinal cord injury. [physio-pedia.com]

Despite this, hypotension persisted and the heart rate remained between 60 and 70 BPM. [wjgnet.com]

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Spinal Cord Transection

It presents with spastic paresis, hyperreflexia, and continued sensory loss. [amboss.com]

Spasticity can reduce venous pooling and stabilize the thoracic and abdominal muscles used in respiration. [americannursetoday.com]

Abstract Orthostatic hypotension commonly occurs in persons with spinal cord injury (SCI), limiting rehabilitation and independence. [ncbi.nlm.nih.gov]

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Autonomic Dysreflexia

When the stage of spinal shock passes, the typical UMN picture within hyperreflexia and spastic paralysis below the level of the injury supervenes. [casemed.case.edu]

He later developed recurrent paroxysmal episodes of abdominal pain, hypertension, skin flushing and headaches. He subsequently was found to have a gastric ulcer. [ncbi.nlm.nih.gov]

Treatment of orthostatic hypotension with fludrocortisone acetate relieved these symptoms. [ncbi.nlm.nih.gov]

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Spinal Trauma

It presents with spastic paresis, hyperreflexia, and continued sensory loss. [amboss.com]

If a paraspinal abscess is present, the patient may experience flank pain, abdominal pain or a limp. [aans.org]

What is the most likely cause of hypotension in a major trauma patient with a possible spinal cord injury? [lifeinthefastlane.com]

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Solvent

Five of six complained of difficulty walking and on examination had spastic paraparesis, distal sensory loss, and hyperreflexia. [ncbi.nlm.nih.gov]

Its ingestion causes rapid central nervous system depression, hypotension, and metabolic acidosis attributable to metabolism of the parent compound to butoxyacetic acid (BAA [doi.org]

Case Report : We present an unusual case of a coingestion of ethanol and 150–250 mL of pure 2BE, which resulted in rapid obtundation, severe airway edema, hypotension, and [doi.org]

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Autoimmune Gastritis

(hyperreflexia) Positive Romberg sign Lhermitte’s sign Segmental cutaneous sensory level Autonomic nervous system Postural hypotension Incontinence Impotence Peripheral nervous [wjgnet.com]

pain and without symptoms to meet criteria for other functional GI disorder that could explain the pain, the diagnosis of functional abdominal pain syndrome, following Rome [journals.lww.com]

Signs and Symptoms of Autoimmune Gastritis: Abdominal pain Anemia, which is characterized by the following symptoms: Weakness Trouble concentrating Shortness of breath Leg [beyondtype1.org]

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Lead Encephalopathy

On clinical examination, the patient showed memory loss, mild disorientation, and weakness in the limbs with bilateral hypertonia and hyperreflexia, plantar upgoing, and spastic [ajnr.org]

He presented with history of abnormal behaviour and unsteadiness of gait for 8 days accompanied by colicky abdominal pain and paraesthesiae in the legs. [jnnp.bmj.com]

Hypotension Transaminase elevations ECG changes Nephrotoxicity secondary to dissociation of EDTA-metal complexes in acidic urine – reduced by ensuring adequate hydration and [lifeinthefastlane.com]

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Scorpion Envenomation

There was a right facial nerve palsy (upper motor neuron type); right spastic hemiplegia with hyperreflexia and extensor plantar response. Fundoscopy was unremarkable. [atmph.org]

Symptoms include: agitation, tachycardia, vomiting, abdominal pain, salivation, diaphoresis, dehydration, muscle rigidity and twitching, tremor, seizures, coma, pupillary [ncbi.nlm.nih.gov]

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X-linked Parkinsonism-Spasticity Syndrome

Clinical manifestations include progressive MUSCLE SPASTICITY; hyperreflexia; MUSCLE RIGIDITY; DYSTONIA; DYSARTHRIA; and intellectual deterioration which progresses to severe [medvik.cz]

Side effects of COMT inhibitors include nausea, vomiting, diarrhoea and abdominal pain. [hse.ie]

Abnormal autonomic nervous system physiology Hypometric saccades Hypotension Optic atrophy Delayed speech and language development Behavioral abnormality Substantia nigra [mendelian.co]

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Hypernatremia

Muscle twitching, tremor, spasticity, hyperreflexia, and lethargy may also be seen. Coma, seizures, and muscle weakness are later signs. [aneskey.com]

pain 9% 0% 14% Neurologic symptom 8% 0% 12% Trauma 4% 0% 3% Hypotension 4% 5% 3% Gastrointestinal bleeding 2% 5% 2% Other Place of origin and personal environment Home 45% [bmcnephrol.biomedcentral.com]

A shunt tap revealed intracranial hypotension with good proximal flow. [ncbi.nlm.nih.gov]

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Coma

[…] with hyperreflexia, quadrispasticity, pupillary fixation to light, decorticate rigidity, decerebrate rigidity. [headinjury.com]

Premonitory symptoms include weakness, anorexia, dry skin and oral cavity, drowsiness, abdominal pain, and fruity breath odor. [medical-dictionary.thefreedictionary.com]

We report 3 cases of spontaneous intracranial hypotension (SIH) associated with consciousness disorder and coma. [ncbi.nlm.nih.gov]

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Spinal Cord Lesion

Commonly results in bladder overactivity or hyperreflexia, (AKA " reflex ", or " spastic " bladder). [rnceus.com]

Certain features of abdominal pain caused by spinal lesions should serve to arouse suspicion as to its true nature. [link.springer.com]

We suggest that rapidly developing hypotension such as that induced by a moderate Valsalva strain represents the instantaneous mechanical effects of a raised intrathoracic [ncbi.nlm.nih.gov]

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Pallidopyramidal Syndrome

Symptoms * Pyramidal signs * Parkinson disease * Tremor * Rigidity * Hyperreflexia * Spastic muscle tone * Gait disturbance * Bradykinesia * Dysarthria * Dysphagia Diagnosis [checkorphan.org]

Hypertension Renal insufficiency Headache Thrombocytopenia Arrhythmia Abdominal pain Abnormality of the kidney Nausea and vomiting Autoimmune thrombocytopenia Confusion Nausea [mendelian.co]

Parkinsonism w orthostatic hypotension Parkinsonism with orthostatic hypotension Parkinsons variant Pigmentary pallidal degeneration Progressive supranuclear ophthalmoplegia [icd9data.com]

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Pregnancy

A total of 31 of the 49 infants (63%) had grossly abnormal results on neurologic examinations; hypertonicity, clonus, hyperreflexia, abnormal movements, spasticity, contractures [nejm.org]

Acute bleeding due to arterial rupture causes severe symptoms, predominantly abdominal pain. [ncbi.nlm.nih.gov]

She was diagnosed with hypotension and hypoxia. Further, fetal heart tones showed bradycardia. [ncbi.nlm.nih.gov]

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HIV-Associated Enteropathy

Symptoms of myelopathy include weakness and sensory changes; upper motor neuron signs, such as spasticity and hyperreflexia, may also be found. Enlarge Print Table 3. [aafp.org]

The presentation, in addition to diarrhea, the most common symptom, includes a variety of features such as dysphagia, nausea, and abdominal pain. [symptoma.com]

On hospital day 9, he developed fever to 38.5 C, tachycardia, worsening hypotension, and peripheral leukocytosis. [ispub.com]

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