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Pelvic Autonomic Dysfunction without Tetraparesis: A Sequel of Rubella‐related Acute Longitudinal Myelitis
Author(s) -
TAKAHASHI Osamu,
SAKAKIBARA Ryuji,
KISHI Masahiko,
OGAWA Emina,
TSUNOYAMA Kuniko,
SUGIYAMA Megumi,
TOMARU Takanobu,
UCHIYAMA Tomoyuki,
YAMANISHI Tomonori
Publication year - 2009
Publication title -
luts: lower urinary tract symptoms
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.451
H-Index - 15
eISSN - 1757-5672
pISSN - 1757-5664
DOI - 10.1111/j.1757-5672.2009.00054.x
Subject(s) - medicine , tetraparesis , myelitis , dyssynergia , spinal cord , constipation , sphincter , defecation , anesthesia , surgery , magnetic resonance imaging , radiology , psychiatry
Objectives: Pelvic autonomic dysfunction without tetraparesis can be a sequel of acute longitudinal myelitis. Methods: A 25‐year‐old woman had suffered from pelvic dysfunction (urinary retention and severe constipation) without tetraparesis for 5 months as a sequel of rubella‐related acute longitudinal myelitis at the spinal segments of C2 to T9. She still had brisk deep tendon reflexes and extensor plantar responses. We performed autonomic function tests in the patient. Results: Pelvic autonomic function tests revealed acontractile detrusor and unrelaxing sphincter, suggesting the shock phase of a suprasacral spinal cord lesion; as well as loss of voluntary sphincter contraction, prolonged colonic transit time, decreased spontaneous phasic contractions, and paradoxical sphincter contraction on defecation, suggesting a suprasacral cord lesion. Conclusion: These findings indicated that the lateral medullary reticulospinal tracts just inside the pyramidal tract, for example, the descending pathways to the bladder and bowel, and the adjacent corticospinal tract to the sphincter, were selectively affected in our case.