Autonomic Dysregulation in Spinal Cord Tumors — Scoping Review

This project is a scoping review examining autonomic dysregulation in patients with spinal cord tumors. Background and purpose. Autonomic dysreflexia and related cardiovascular autonomic dysfunction are extensively characterized in traumatic spinal cord injury, where lesions at or above the sixth thoracic segment disrupt supraspinal control of sympathetic outflow. In contrast, autonomic dysregulation arising from neoplastic spinal cord pathology has never been systematically synthesized. The existing tumor literature consists only of scattered individual case reports and a single small case series; even review-level work on the traumatic side references neoplastic cases as isolated citations without synthesizing them. The purpose of this review is to map the full published evidence on autonomic dysregulation in spinal cord tumors — across tumor types, spinal levels, autonomic domains, mechanisms, and perioperative course — and to define the boundaries of what is known. Methods. Following JBI scoping-review methodology and PRISMA-ScR reporting standards, we conducted a structured literature search (PubMed/MEDLINE, extended to additional databases), identifying 127 records. Two reviewers independently screened all records in blinded mode and reconciled to full agreement using pre-specified scope rules governing autonomic domain, focal sympathetic syndromes, anatomical level, and lesion type. Included sources will undergo dual-reviewer full-text screening and structured data charting. Findings will be presented descriptively and contrasted against the volume and maturity of the traumatic-SCI autonomic literature. Expected outcomes. We expect to find that autonomic dysregulation in spinal cord tumors is documented only as sparse, fragmented case reports, with no prior synthesis — confirming a genuine evidence gap in an under-recognized but clinically important phenomenon. The review will characterize the reported cases, identify patterns by tumor type and spinal level, describe a focal-sympathetic subgroup, and propose a research agenda. This registration documents the protocol and completed screening prior to full-text charting.