Research paper
Micturitional disturbance in acute disseminated encephalomyelitis (ADEM)

https://doi.org/10.1016/0165-1838(96)00054-9Get rights and content

Abstract

In eleven patients with acute disseminated encephalomyelitis (ADEM), micturitional histories taken during the acute stage revealed that nine were in a state of urinary retention, and the other two had urinary frequency and urge incontinence together with difficulty it voiding. After the follow-up period of 3 to 38 months seven of nine patients with retention became able to urinate, but five of them had difficulty in voiding and four of them developed urinary frequency or urge incontinence. Two patients had urinary retention even after 26 and 38 months from the onset. Ten patients underwent urodynamic studies and disclosed detrusor hyperreflexia in six, low compliance bladder in two, atonic cystometrogram in one and detrusor-sphincter dyssynergia in two patients. Motor unit analysis of the externa sphincter revealed polyphasic neurogenic changes in one of four patients. The results were compared with our previous findings it multiple sclerosis (MS), and we found that micturitional disturbance in ADEM seemed to be as common and as severe as in MS Supranuclear as well as nuclear types of pelvic and pudendal nerve dysfunction seemed to be responsible for micturitional disturbance it our patients with ADEM. Micturitional disturbance seemed to be related to the pyramidal tract involvement, and probably reflecting the severity of spinal cord lesions.

References (19)

  • J.G. Blaivas et al.

    Detrusor-sphincter dyssynergia: A detailed electromyographic study

    J. Urol.

    (1981)
  • J.G. Sislow et al.

    Reduction in human bladder wall compliance following decentralization

    J. Urol.

    (1990)
  • R.D. Adams et al.

    Principle of Neurology

  • E.C. Alford

    Disseminated encephalomyelitis: Its variations in form and their relationships to other diseases of the nervous system

  • C.D. Betts et al.

    Urinary symptoms and the neurological features of bladder dysfunction in multiple sclerosis

    J. Neurol. Neurosurg. Psychiatry

    (1993)
  • J. Booss et al.

    Viral Encephalitis: Pathology, Diagnosis and Management

  • L. Davis et al.

    Significance of electromyographic changes in the external urinary sphincter

    Neurol. Urodynam.

    (1986)
  • J.G. Greenfield

    Acute disseminated encephalomyelitis as a sequel to ‘influenza’

    J. Pathol. Bacteriol.

    (1930)
  • T. Hattori et al.

    Micturitional disturbance in cervical spondylotic myelopathy

    J. Spinal Disord.

    (1990)
There are more references available in the full text version of this article.

Cited by (37)

  • Adult onset acute disseminated encephalomyelitis: A case report

    2021, Radiology Case Reports
    Citation Excerpt :

    Intravenous methylprednisolone is the first-line drug for 3-5 days are being used (Class IV) [7,12,13]. Methylprednisolone-treated patients had significantly better outcome with respect to disability status when compared with those treated with dexamethasone [14]. However, these regimens are not based on controlled randomized trials.

  • Acute and chronic urine retention among adults at the urology section of the Accident and Emergency Unit of Komfo Anokye Teaching Hospital, Kumasi, Ghana

    2015, African Journal of Urology
    Citation Excerpt :

    Abrams et al. assigned an arbitrary figure of 300 ml of residual urine after voiding as the minimum volume required for the definition of CUR [59]. Some investigators defined CUR as PVR urine of more than 400 ml [60], or a post-void volume of 100–500 ml [61]; others have not given it a definite volume [62]. George et al. defined high-pressure CUR as raised intrinsic detrusor pressure during the filling phase of micturition [63] with an intravesical pressure above 25 cm H2O, leading to a bladder volume of >800 ml and often accompanied by hydronephrosis [64–66].

  • Neurogenic lower urinary tract dysfunction

    2013, Handbook of Clinical Neurology
    Citation Excerpt :

    Practical guidelines for management and follow-up for neurogenic bladder have been proposed for patients with MS in the UK (Fowler et al., 2009) and French-speaking countries (de Seze et al., 2007). Lower urinary tract dysfunction occurs often in acute disseminated encephalomyelitis and may persist after other neurological deficits have resolved (Sakakibara et al., 1996b; Panicker et al., 2009). Detrusor sphincter dyssynergia and detrusor overactivity are the hallmarks of spinal cord injury (see Fig. 17.4A,B).

  • Autonomic dysfunction: A unifying multiple sclerosis theory, linking chronic cerebrospinal venous insufficiency, vitamin D<inf>3</inf>, and Epstein-Barr virus

    2012, Autoimmunity Reviews
    Citation Excerpt :

    Similarly, Hashimoto encephalopathy is often associated with autoimmune tyroiditis [161] which involves cardiovascular ANS dysfunction as part of its underlying pathology [162]. Furthermore, similarities in ANS dysfunction between acute disseminated encephalomyelitis and MS have also been reported [163]. ANS dysfunction has also been reported in other neurological diseases, including Parkinson's disease [164], Trigeminal neuralgia and associated migraine and headache [165], chronic inflammatory demyelinating polyneuropathy [166] and complete transverse myelitis [167].

View all citing articles on Scopus
View full text