Acute urine retention as a clinically isolated syndrome (a case report)

We report a case of 24 years old women with clinically isolated syndrome (CIS) presenting predominantly with acute urine retention. After slight febrile disorder she got acute urine retention. Urologists excluded their nosologies and the patient was sent to our clinic to visit neurologist. At the time of admission the only complain was urine retention. Her neurological and mental status was normal. Her brain and spinal cord MRI revealed pontine demyelination in the right rostral tegmentum (T2se and Flair hyperintensity). Nerve conduction study of lower extremities showed no peripheral nerve lesion. Under the diagnosis of clinically isolated syndrome steroids were prescribed and the patient recovered fully. Urine retention was explained to be a consequence of tegmental demyelinating lesion as it should be a location of Barrington urination centre. Several functional imaging studies confirmed pontine implication in micturition control although the exact site is still missing. Very few cases are reported ascribing unilateral lesion associated with urine retention. We believe our case is one more clear confirmation of unilateral pontine location of supraspinal urination center.