Paroxysmal urinary incontinence associated with multiple sclerosis

We report a patient with multiple sclerosis who manifested urinary incontinence as a part of paroxysmal attacks which were characterized by sudden onset, short duration, and frequent repetition. This phenomenon has not been described previously. Urodynamic study during paroxysmal attacks revealed uninhibited detrusor contractions with coordinated relaxation of external urethral sphincter muscle. Neurological examination and magnetic resonance imaging suggested that paroxysmal urinary incontinence was induced by an ectopic excitation of the demyelinating lesion in the right rostral pons, the location of which was similar to the pontine micturition center reported in previous animal experiments. Treatment with carbamazepine, an antiepileptic drug, suppressed the attacks including the associated urinary incontinence.