1/11. Autonomic failure and proximal skeletal myopathy in a patient with primary Sjogren syndrome.Autonomic failure and proximal skeletal myopathy are rare features of the Sjogren syndrome (SS). We describe a 51-year-old woman with primary SS who had development of esophageal dysmotility, urinary retention, severe orthostatism, and skeletal myopathy during a 3-month period after the diagnosis of SS. Her symptoms and signs responded well to corticosteroid therapy. Although dysfunction of the peripheral nervous system has a prevalence rate of 20% in patients with SS, most commonly the nerve dysfunction is a sensory deficit, and autonomic neuropathy is less frequent. Autonomic neuropathy due to SS may be underreported. The cause of our patient's myopathy remains undetermined. We speculate that the myopathy was due to either a form of polymyositis or an immune-mediated neuropathy with muscle involvement.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/11. Severe bradyarrhythmia in a patient with Alzheimer's disease and a patient with cerebral ischaemia, both induced by acute distension of the bladder.Two case reports are presented of bradycardia in two elderly patients, which was resistant to atropine but which resolved immediately the acute bladder distension was treated. Generally, a sympathetic cardiac response is expected, and this paradoxical response may be due not only to lesions of the reflex loop involving both the vagal and the sympathetic nerves, but also to endocrinological factors. As acute urinary distension is not uncommon on geriatric wards, bradyarrhythmia due to bladder distension should be considered in elderly patients.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
3/11. A case of neuropsychiatric lupus with myelopathy successfully treated with corticosteroids.This report describes a 16-year old female patient who presented with acute paresis in both lower limbs, acute urinary retention, blurred vision and arthritis. The patient was diagnosed as having systemic lupus erythematosus with myelitis and bilateral abducent nerves palsy. The administration of steroids resulted in marked improvement in her neurological symptoms.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
4/11. Delayed uterine re-inversion: a unique symptom complex.A case of late recurrence of uterine inversion is presented. Symptoms included constipation and urinary retention without uterine bleeding. Symptoms resolved 3 months after the replacement of the uterus. It is hypothesized that the symptoms were related to stretch injury to the pelvic parasympathetic nerves. Timely intervention may prevent long-term sequelae.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
5/11. Acute urinary retention attributable to sacral herpes zoster.Acute urinary retention in women is uncommon. A 63 year old woman presented with suprapubic pain, a palpable bladder, and multiple grouped vesicles on the right buttock. Catheterisation showed a residual of 2000 ml. A case is reported of acute urinary retention secondary to herpes zoster infection of the sacral nerves (S2-4).- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
6/11. Orthopedic pitfalls: cauda equina syndrome.low back pain is an extremely common complaint encountered by emergency and primary care physicians. Although the majority of patients have uncomplicated benign presentations, there is a small subset who has a much more severe disease process called cauda equina syndrome, which entails acute compression of the nerve roots of the cauda equina. These patients usually present posttraumatically with the triad of saddle anesthesia, bowel or bladder dysfunction, and lower extremity weakness. Significant morbidity can result from delayed diagnosis and treatment; therefore, the emergency physician should remain aware of this potential orthopedic pitfall. This case report discusses the clinical presentation, diagnosis, and relevant treatment of cauda equina syndrome in the ED.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
7/11. meningitis-retention syndrome. An unrecognized clinical condition.BACKGROUND: A combination of acute urinary retention and aseptic meningitis has not been well known. This combination can be referred to as meningitis-retention syndrome (MRS), when accompanied by no other abnormalities. OBJECTIVE: To describe the results of a uro-neurological assessment in our patients with MRS. methods: In three patients (two men, one woman; age, 34-68 years), we performed urodynamic studies and relevant imaging and neurophysiological tests, in addition to cerebrospinal fluid (CSF) examination. RESULTS: All three patients developed acute urinary retention along with headache, fever and stiff neck.None had obvious neurological abnormalities, other than a slightly brisk reflex in the lower extremities. One had previously experienced generalized erythematous eruptions, but none had pain, hypalgesia or skin eruptions in the sacral dermatomes suggestive of Elsberg syndrome (infectious sacral polyradiculitis; mostly genital herpes). brain/spinal/lumbar plexus MRI scans and nerve conduction studies were normal. CSF examination showed mild mononuclear pleocytosis, increased protein content, and normal to mildly decreased glucose content in all patients; increased myelin basic protein suggestive of central nervous system demyelination in one; and increased viral titers in none.Urodynamic study revealed, during the voiding phase, an underactive detrusor in all patients and an unrelaxing sphincter in one. These clinical manifestations were ameliorated within 3 weeks. CONCLUSIONS: We reported three cases of MRS, a peculiar syndrome that could be regarded as a mild variant of acute disseminated encephalomyelitis (ADEM). urinary retention might reflect acute shock phase of this disorder. Although MRS has a benign and self-remitting course, management of the acute urinary retention is necessary.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
8/11. urinary retention during sacral nerve stimulation for faecal incontinence: report of a case.Sacral nerve stimulation (SNS) was proposed for the treatment of patients with urologic symptoms in 1967 but was not used until 1981. SNS has also proven to be a promising treatment in idiopathic faecal incontinence when conventional treatments have failed. The modality has been used for faecal incontinence since the mid-1990s. Eighty percent of the patients who were selected for percutaneous nerve evaluation (PNE) because of faecal incontinence report an improvement in the symptoms and qualify for a permanent implantation. Accordingly, SNS is now used for faecal incontinence and urologic symptoms. reflex interactions between the bladder and the distal gastrointestinal tract are well known. The present case shows that SNS for faecal incontinence may significantly influence bladder function.- - - - - - - - - - ranking = 6keywords = nerve (Clic here for more details about this article) |
9/11. urinary retention due to sacral myeloradiculitis: a clinical and neurophysiological study.We report 5 cases of sacral myeloradiculitis presenting with transient urinary retention. Neurophysiological testing, including bulbocavernosus reflex, pudendal evoked response and external anal sphincter electromyography, was performed. Parasympathetic pelvic nerves, pudendal nerves as well as the spinal cord seem to be involved to various degrees in this infrequent disorder.- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |
10/11. cisapride enhances detrusor contractility and improves micturition in a woman with lazy bladder.A 32-year-old woman with lazy bladder was treated with cisapride (10 mg q.i.d.) for three weeks, obtaining a progressive improvement of the symptomatology and urodynamic parameters, and the return to pretreatment conditions after drug withdrawal. This case agrees with the evidence that cisapride potentiates the release of acetylcholine from postganglionic cholinergic nerves in the human isolated detrusor by activating 5-HT4 receptors, i.e. through the same mechanism responsible for its gastrointestinal prokinetic action. It is concluded that selective 5-HT4 agonists could be potentially useful to improve bladder emptying in micturition disorders associated with detrusor hypocontractility.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
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