Successful treatment of overactive bladder in a child with myasthenia gravis

Abstract

Detrusor overactivity in patients with congenital myasthenia gravis is a rare finding. Owing to the underlying disease, anticholinergic treatment is not possible. We present the case of a 6-year-old child in whom a significant improvement was achieved by means of functional electrical stimulation.

The impact of myasthenia gravis on lower urinary tract functions

“…To elucidate the probable effect of cholinesterase inhibitors on detrusor muscle, our study was conducted on myasthenic patients free of those drugs. In accordance with the previous reports, 20‐22 our patients with MG complained of the symptoms of LUT dysfunction. In addition, OABSS symptom scores markedly increased in patients with myasthenia compared with healthy controls.…”

“…19 On the other hand, Pannek and Grigoleit reported a 6-year-old boy who had congenital MG and suffered from OAB starting after initiating pyridostigmine and improving through functional electrical stimulation. 20 Likewise, Antoniou et al recovered urodynamic detrusor overactivity by using pretibial nerve stimulation in a young myasthenic woman. 21 Wright et al presented two comorbid MG and OAB cases successfully cured with intra-detrusor Botox.…”

“…Marouani et al retained bladder dysfunction with urethral sphincter hypertonia and detrusor areflexia in a myasthenic girl 19 . On the other hand, Pannek and Grigoleit reported a 6‐year‐old boy who had congenital MG and suffered from OAB starting after initiating pyridostigmine and improving through functional electrical stimulation 20 . Likewise, Antoniou et al recovered urodynamic detrusor overactivity by using pretibial nerve stimulation in a young myasthenic woman 21 .…”

Successful treatment of urodynamic detrusor over-activity in a young patient with Myasthenia gravis using pretibial nerve stimulation with follow-up to two years

“…However, there was a return of symptoms of incontinence immediately upon discontinuation of the stimulation. 6 The difference in this report is use of a percutaneous technique with nerve stimulation over a 12-week period as compared to the surface electrodes used in the case of the six-year-old boy, with a six-week period, and use of the pretibial rather than suprapubic approach. Detrusor underactivity though rare in Myasthenia is more common than is overactive bladder in this disease.…”

Electrical stimulation for lower urinary tract dysfunction in children: A systematic review of the literature

“…Seventeen papers fulfilled the inclusion criteria 10–24. Two articles were excluded because the outcomes in patients with LUTD were not differentiated from those with neurogenic bladder dysfunction, and one study because it evaluated electrical stimulation in a child with myasthenia gravis 25–27. Tables I–III summarize the results.…”