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Behavioral effects of long-term antimuscarinic use in patients with spinal dysraphism: a case control study
Paul W Veenboer1, Jaap Huisman, Rafal J Chrzan
1Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands.
Insights
Long-term antimuscarinic use in children with spinal dysraphism and neurogenic bladder did not show significant associations with behavioral problems. This study found no differences in behavior between children using antimuscarinics and those who were not.
Area of Science:
- Pediatric Neurology
- Urology
- Developmental Pediatrics
Background:
- Spinal dysraphism and neurogenic bladder frequently lead to urinary incontinence.
- Antimuscarinic medications are commonly used to manage detrusor overactivity in these children.
- Concerns exist regarding potential behavioral side effects of long-term antimuscarinic use.
Purpose of the Study:
- To investigate the association between long-term antimuscarinic medication use and behavioral problems in children with spinal dysraphism.
- To compare behavioral outcomes in children with spinal dysraphism who received antimuscarinics versus those who did not.
Main Methods:
- A case-control study was conducted with 32 children diagnosed with spinal dysraphism.
- Participants were recruited from two pediatric hospitals in the Netherlands.
- Behavioral problems were assessed using the Child Behavior Checklist, with cases (antimuscarinic users) matched to controls (non-users).
Main Results:
- No statistically significant differences in overall behavioral problem scores were observed between children using antimuscarinics and the control group.
- Analysis of specific behavioral subdomains also revealed no significant differences between the groups.
- Key demographic and clinical factors, including hydrocephalus and drain status, were similar between cases and controls.
Conclusions:
- Long-term antimuscarinic treatment in children with spinal dysraphism and neurogenic bladder does not appear to be associated with increased behavioral problems.
- These findings suggest that antimuscarinics can be safely used for managing neurogenic bladder in this pediatric population without significant behavioral concerns.
- Further research may explore other potential factors influencing behavior in children with spinal dysraphism.
Purpose:
We explored possible associations between long-term antimuscarinic use and behavioral problems in children with spinal dysraphism and neurogenic bladder.
Materials And Methods:
Children with open and closed spinal dysraphism were recruited from 2 pediatric hospitals, 1 in Amsterdam and 1 in Utrecht, The Netherlands. At the Amsterdam facility antimuscarinics were prescribed in selected patients with detrusor overactivity. At the Utrecht facility antimuscarinics were prescribed from birth onward in patients with spinal dysraphism beginning in the early 1990s. Parents of study participants were asked to fill out a Child Behavior Checklist. Demographics, data on level and type(s) of lesion, and presence of hydrocephalus with a drain (and, if applicable, number of drain revisions) were retrieved for each patient. Cases and controls (8 boys and 8 girls per group) were matched on a 1-to-1 basis.
Results:
Data on 32 children were analyzed. Median age was 10.6 years in cases and 10.5 years in controls (p=0.877). In each group 9 of 16 patients had hydrocephalus with a drain. No significant difference in Child Behavior Checklist scores for total problems was found between cases and controls (median 52.0 vs 59.5, p=0.39). No differences were found between the groups on any subdomain of the Child Behavior Checklist.
Conclusions:
No significant differences in behavior were found between children with spinal dysraphism with and without long-term use of antimuscarinics.
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