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Difficult defaecation and/or faecal incontinence as a presenting feature of neurologic disorders in four patients
Author(s) -
BARDOUX N.,
LEROI A. M.,
TOUCHAIS J.Y.,
WEBER J.,
DENIS P.
Publication year - 1997
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1046/j.1365-2982.1997.d01-2.x
Subject(s) - medicine , weakness , orthostatic vital signs , etiology , urinary incontinence , defecation , fecal incontinence , neurological examination , perineum , surgery , blood pressure
We report four cases of difficult defaecation and/or faecal incontinence revealing a neurologic disease. These anorectal symptoms were associated with urinary disorders, but urinary symptoms always appeared several years after anorectal complaints. Clinical neurologic examination immediately led us to suspect a neurologic aetiology in two patients with the following signs: perineal hypoesthesia, absence of voluntary anal contraction and anal reflexes in one subject (final diagnosis: L1 neurinoma), and in the other a weakness in both thighs with absent tendon reflexes in the four limbs (final diagnosis: amiodarone neuropathy). In the two other patients with multiple cerebral infarction or multiple system atrophy, the neurologic aetiology was suspected on the absence of anal voluntary contraction contrasting with a normal perineal anatomy, but the final diagnosis was made only two years later when orthostatic arterial hypotension occurred .