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Bladder and bowel dysfunction in chronic inflammatory demyelinating polyradiculoneuropathy.
Kazuhiro Ishii1, Akira Tamaoka, Youshi Fujita
1Department of Neurology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Ten'noudai, Tsukuba-shi, Ibaraki-ken, 305-8575, Japan.
European Journal of Internal Medicine
|June 22, 2005
Summary
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) can cause severe bladder and bowel dysfunction (BBD) due to enlarged nerve roots. Steroid treatment improved neurological symptoms but not BBD in this case.
Area of Science:
- Neurology
- Urology
- Gastroenterology
Background:
- Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an autoimmune disorder affecting peripheral nerves.
- Bladder and bowel dysfunction (BBD) can be a debilitating complication of neurological conditions.
- Late-onset BBD in CIDP patients is not well-documented.
Purpose of the Study:
- To report a case of severe BBD developing 10 years after CIDP onset.
- To investigate the potential cause of BBD in this CIDP patient.
- To evaluate the treatment response of BBD to corticosteroids.
Main Methods:
- Clinical case presentation.
- Cystometry to assess bladder function.
- Magnetic resonance imaging (MRI) of the lumbosacral spine.
Main Results:
- The patient presented with constipation, urinary urgency, and voiding difficulty.
- Cystometry revealed impaired bladder sensation and detrusor areflexia.
- MRI demonstrated enlarged, space-occupying nerve roots in the lumbosacral canal, presumed cause of BBD.
- Intravenous methylprednisolone and oral prednisolone improved sensory disturbances and muscle weakness but not BBD.
Conclusions:
- Severe BBD can manifest late in the course of CIDP.
- Enlarged lumbosacral nerve roots may cause BBD in CIDP.
- Corticosteroid therapy may not effectively treat CIDP-associated BBD.