Intestinal PseudoObstruction in Acute Myelitis

Kanesaka, Toshihide; Sakakibara, Ryuji; Ito, Shingo; Ito, Takashi; Odaka, Takeo; Yamaguchi, Taketo; Uchiyama, Tomoyuki; Liu, Zhi; Yamamoto, Tatsuya; Hattori, Takamichi

doi:10.2169/internalmedicine.45.1540

Cited by 14 publications

(9 citation statements)

References 3 publications

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“…Both the sacral cord and the vagus nuclei receive projecting fibers from Barrington's nucleus (identical to the PMC) in the pons. The spinal descending pathway for defecation is located in the lateral columns in humans [129, 130]. In the acute stage of spinal cord injury [131] or multiple sclerosis [132], CTT is significantly prolonged.…”

Section: Bowel Dysfunction In Pdmentioning

confidence: 99%

Bladder, Bowel, and Sexual Dysfunction in Parkinson's Disease

Sakakibara

Kusumoto

Ogawa

et al. 2011

Parkinson's Disease

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Bladder dysfunction (urinary urgency/frequency), bowel dysfunction (constipation), and sexual dysfunction (erectile dysfunction) (also called “pelvic organ” dysfunctions) are common nonmotor disorders in Parkinson's disease (PD). In contrast to motor disorders, pelvic organ autonomic dysfunctions are often nonresponsive to levodopa treatment. The brain pathology causing the bladder dysfunction (appearance of overactivity) involves an altered dopamine-basal ganglia circuit, which normally suppresses the micturition reflex. By contrast, peripheral myenteric pathology causing slowed colonic transit (loss of rectal contractions) and central pathology causing weak strain and paradoxical anal sphincter contraction on defecation (PSD, also called as anismus) are responsible for the bowel dysfunction. In addition, hypothalamic dysfunction is mostly responsible for the sexual dysfunction (decrease in libido and erection) in PD, via altered dopamine-oxytocin pathways, which normally promote libido and erection. The pathophysiology of the pelvic organ dysfunction in PD differs from that in multiple system atrophy; therefore, it might aid in differential diagnosis. Anticholinergic agents are used to treat bladder dysfunction in PD, although these drugs should be used with caution particularly in elderly patients who have cognitive decline. Dietary fibers, laxatives, and “prokinetic” drugs such as serotonergic agonists are used to treat bowel dysfunction in PD. Phosphodiesterase inhibitors are used to treat sexual dysfunction in PD. These treatments might be beneficial in maximizing the patients' quality of life.

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Section: Bowel Dysfunction In Pdmentioning

confidence: 99%

Bladder, Bowel, and Sexual Dysfunction in Parkinson's Disease

Sakakibara

Kusumoto

Ogawa

et al. 2011

Parkinson's Disease

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“…Tibial somatosensory evoked potentials were normal in our case. These findings indicated that the lateral medullary reticulospinal tract [10,13,15,16] just inside the pyramidal tract, e.g. the descending pathway to the bladder and the bowel, was selectively affected in our case.…”

Section: Discussionmentioning

confidence: 52%

Pelvic Autonomic Dysfunction without Paraplegia: A Sequel of Spinal Cord Stroke

et al. 2008

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“…In particular, in a myelitis case with urinary retention reported by Hiraga et al, an MRI scan revealed two separate, bilateral lesions in the lateral portion of the spinal cord 9 . Similarly, in a possible case of ADEM with severe constipation reported by Kanesaka et al, an MRI scan revealed two separate, bilateral lesions in the lateral portion of the spinal cord 10 . These lesions involved the lateral medullary reticulospinal tract 12–14 just inside the pyramidal tract (i.e.…”

Section: Discussionmentioning

confidence: 90%

“…Similarly, Hiraga et al reported a man with acute myelitis, who had mild spastic paraparesis and decreased sensation below the level of T6 dermatome, both of which soon disappeared completely, whereas his urinary retention persisted for over a year 9 . Kanesaka et al reported a man with presumable ADEM, who had drowsiness and paraplegia without sensory disturbances 10 . Steroid pulse therapy resolved his paraplegia completely, leaving postvoid residuals and constipation as the sole sequels.…”

Section: Discussionmentioning

confidence: 96%

“…9 Kanesaka et al reported a man with presumable ADEM, who had drowsiness and paraplegia without sensory disturbances. 10 Steroid pulse therapy resolved his paraplegia completely, leaving postvoid residuals and constipation as the sole sequels. Therefore, not only spinal conus lesion (sacral) or cauda equina compression (infrasacral), but also cervicothoracic myelitis (suprasacral), including the present case, can present with pelvic autonomic dysfunction as the sole clinical manifestation.…”

Section: Discussionmentioning

confidence: 99%

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Pelvic Autonomic Dysfunction without Tetraparesis: A Sequel of Rubella‐related Acute Longitudinal Myelitis

Takahashi

Sakakibara

Kusumoto

et al. 2009

LUTS

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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.

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Intestinal PseudoObstruction in Acute Myelitis

Cited by 14 publications

References 3 publications

Bladder, Bowel, and Sexual Dysfunction in Parkinson's Disease

Bladder, Bowel, and Sexual Dysfunction in Parkinson's Disease

Pelvic Autonomic Dysfunction without Paraplegia: A Sequel of Spinal Cord Stroke

Pelvic Autonomic Dysfunction without Tetraparesis: A Sequel of Rubella‐related Acute Longitudinal Myelitis

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