Bladder and bowel dysfunction in chronic inflammatory demyelinating polyradiculoneuropathy

Ishii, Kazuhiro; Tamaoka, Akira; Fujita, Youshi; Shoji, Shin'ichi

doi:10.1016/j.ejim.2004.10.021

« Previous Next »European Journal of Internal Medicine
Volume 16, Issue 3 , Pages 211-213, June 2005

Bladder and bowel dysfunction in chronic inflammatory demyelinating polyradiculoneuropathy

Department of Neurology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Ten'noudai, Tsukuba-shi, Ibaraki-ken, 305-8575, Japan

Received 3 September 2004; received in revised form 14 September 2004; accepted 5 October 2004.

Abstract

We present a patient with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) who developed severe bladder and bowel dysfunction (BBD) as evidenced by constipation, voiding difficulty, and urinary urgency. These symptoms appeared 10 years after onset of CIDP. Cystometry showed disturbance of bladder sensation and detrusor areflexia. Magnetic resonance imaging (MRI) showed greatly enlarged nerve roots filling the lumbosacral spinal canal; this appeared to be the likely cause of BBD. A 3-day course of intravenous methylprednisolone (1 g/day), followed by 30 mg/day of oral prednisolone, ameliorated the sensory disturbance and muscle weakness, but not BBD.

Keywords: Nerve root hypertrophy, Pulse steroid therapy, Constipation, Bladder sensation, Detrusor areflexia, Spinal cord compression, Cauda equina