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Related Experiment Videos

Paroxysmal urinary incontinence associated with multiple sclerosis

N Yoshimura1, Y Nagahama, T Ueda

  • 1Department of Urology, Faculty of Medicine, Kyoto University, Japan. nyos+@pitt.edu

Urologia Internationalis
|January 1, 1997
PubMed
Summary

This study describes a unique case of paroxysmal urinary incontinence in a multiple sclerosis patient. Carbamazepine effectively treated these episodes by suppressing ectopic excitations in the brain.

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Area of Science:

  • Neuroscience
  • Urology
  • Neurology

Background:

  • Multiple sclerosis (MS) is a chronic demyelinating disease affecting the central nervous system.
  • Urinary dysfunction is a common symptom in MS, but paroxysmal incontinence is rarely reported.
  • Understanding the neuroanatomical basis of MS-related bladder dysfunction is crucial for effective management.

Observation:

  • A patient with multiple sclerosis presented with sudden, brief, and frequent episodes of urinary incontinence.
  • Urodynamic studies during these attacks showed involuntary bladder muscle contractions (detrusor) with simultaneous relaxation of the external urethral sphincter.
  • Neurological assessment and MRI indicated the incontinence originated from ectopic excitation of a demyelinating lesion in the right rostral pons.

Findings:

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  • The observed paroxysmal urinary incontinence in MS is a novel clinical manifestation.
  • The pontine micturition center's proximity to the lesion suggests a neuroanatomical link.
  • Carbamazepine, an antiepileptic medication, successfully abolished the incontinent episodes.

Implications:

  • This case highlights a previously undescribed presentation of urinary dysfunction in multiple sclerosis.
  • It suggests that focal demyelinating lesions can induce paroxysmal autonomic symptoms.
  • Targeting ectopic neuronal excitation with medications like carbamazepine may offer a therapeutic strategy for such cases.