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Micturitional disturbance in acute disseminated encephalomyelitis (ADEM)
R Sakakibara1, T Hattori, K Yasuda
1Department of Neurology, Kashima Rosai Hospital, Japan.
Journal of the Autonomic Nervous System
|September 12, 1996
Summary
Urinary retention and voiding difficulties are common in acute disseminated encephalomyelitis (ADEM). These micturitional disturbances, similar to multiple sclerosis, may stem from nerve dysfunction and spinal cord lesions.
Area of Science:
- Neuroscience
- Urology
Background:
- Acute disseminated encephalomyelitis (ADEM) can cause neurological deficits.
- Micturitional dysfunction is a known complication in some neurological disorders.
Purpose of the Study:
- To investigate the prevalence and characteristics of micturitional disturbances in patients with ADEM.
- To compare these disturbances with those observed in multiple sclerosis (MS).
Main Methods:
- Micturitional histories were collected during the acute stage and follow-up.
- Urodynamic studies were performed in ten patients.
- External sphincter motor unit analysis was conducted in four patients.
Main Results:
- Nine of eleven ADEM patients experienced urinary retention acutely; two had frequency and incontinence.
- At follow-up, retention persisted in two patients, while others developed voiding difficulties or incontinence.
- Urodynamic findings included detrusor hyperreflexia, low compliance bladder, atonic cystometrogram, and detrusor-sphincter dyssynergia.
Conclusions:
- Micturitional disturbances in ADEM are common and can be severe, comparable to MS.
- Dysfunctions likely involve supranuclear and nuclear pelvic/pudendal nerve pathways.
- Symptoms may correlate with pyramidal tract involvement and spinal cord lesion severity.