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Related Experiment Videos

Brainstem Stroke and Increased Anal Tone.

Fuyuki Tateno1, Ryuji Sakakibara1, Masahiko Kishi1

  • 1Division of Neurology, Department of Internal Medicine, Sakura Medical Center, Toho University, Sakura, JapanDivision of Gastroenterology, Department of Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan.

Lower Urinary Tract Symptoms
|December 18, 2015
PubMed
Summary
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A brainstem stroke caused locked-in syndrome in a 62-year-old man, leading to increased anal tone. This symptom, unresponsive to treatment, was linked to damage in the pons and cerebellum.

Area of Science:

  • Neurology
  • Neuroscience
  • Clinical Medicine

Background:

  • Brainstem strokes can cause complex neurological deficits.
  • Locked-in syndrome is a rare condition characterized by paralysis and preserved consciousness.
  • Pontine lesions may affect autonomic functions, including bowel control.

Purpose of the Study:

  • To report a case of locked-in syndrome with intractable increased anal tone following a brainstem stroke.
  • To investigate the neuroanatomical correlates of increased anal tone in this patient.
  • To discuss the potential role of Barrington's nucleus and the rostral pontine reticular formation in defecation control.

Main Methods:

  • Case report of a 62-year-old male patient.
  • Clinical assessment including neurological examination.
Keywords:
anal tonebrainstem strokepontine defecation center

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  • Magnetic resonance imaging (MRI) to identify the stroke lesion.
  • Review of relevant literature on pontine function and defecation.

    • Main Results:

    • The patient presented with locked-in syndrome, loss of horizontal eye movement, and intractable increased anal tone.
    • MRI revealed a massive stroke in the pons and right cerebellum.
    • The lesion appeared to involve Barrington's nucleus and the rostral pontine reticular formation (RPRF).
    • Medical management for increased anal tone was ineffective, necessitating intermittent catheterization.

    Conclusions:

    • Lesions involving the pontine defecation center (Barrington's nucleus) and RPRF may lead to intractable increased anal tone.
    • This case highlights the complex role of the brainstem in regulating bowel function.
    • Further research is needed to fully elucidate the neural pathways involved in defecation control.