Abstract
Background
A combination of acute urinary retention and aseptic meningitis has not been well known. This combination can be referred to as meningitis–retention syndrome (MRS), when accompanied by no other abnormalities.
Objective
To describe the results of a uro–neurological assessment in our patients with MRS.
Methods
In three patients (two men, one woman; age, 34–68 years), we performed urodynamic studies and relevant imaging and neurophysiological tests, in addition to cerebrospinal fluid (CSF) examination.
Results
All three patients developed acute urinary retention along with headache, fever and stiff neck.None had obvious neurological abnormalities, other than a slightly brisk reflex in the lower extremities. One had previously experienced generalized erythematous eruptions, but none had pain, hypalgesia or skin eruptions in the sacral dermatomes suggestive of Elsberg syndrome (infectious sacral polyradiculitis; mostly genital herpes). Brain/spinal/lumbar plexus MRI scans and nerve conduction studies were normal. CSF examination showed mild mononuclear pleocytosis, increased protein content, and normal to mildly decreased glucose content in all patients; increased myelin basic protein suggestive of central nervous system demyelination in one; and increased viral titers in none.Urodynamic study revealed, during the voiding phase, an underactive detrusor in all patients and an unrelaxing sphincter in one. These clinical manifestations were ameliorated within 3 weeks.
Conclusions
We reported three cases of MRS, a peculiar syndrome that could be regarded as a mild variant of acute disseminated encephalomyelitis (ADEM). Urinary retention might reflect acute shock phase of this disorder. Although MRS has a benign and selfremitting course, management of the acute urinary retention is necessary.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Wheeler JS Jr, Culkin DJ, Walter JS, Flanigan RC (1990) Female urinary retention. Urology 35:428–432
Herbaut AG (1993) Neurogenic urinary retention. Int Urogynecol J 4:221–228
Sakakibara R, Hattori T, Uchiyama T, Kamura K, Yamanishi T (2003) Uroneurological assessment of spina bifida cystica and occulta. Neurourol Urodynam 22:328–334
Kanno R, Yokoyama J, Takagi Z (1985) Aseptic meningitis associated with urinary retention. Annu Rep Ohara Hosp 28:51–54 (in Japanese with English Abstract)
Ohe C, Ohashi Y (1990) A case of urinary retention secondary to aseptic meningitis. Rinshou Hinyoukika 44:911–913 (in Japanese with English Abstract)
Fukagai T, Ishihara M, Funabashi K, Naitoh Y, Murayama K (1996) A case of urinary retention secondary to aseptic meningitis. Rinshou Hinyoukika 50:67–70 (in Japanese with English Abstract)
Shimizu Y, Yamamoto S, Inoue K (1999) Two cases of urinary retention secondary to aseptic meningitis. Acta Urol Jpn 45:435–437 (in Japanese with English Abstract)
Zenda T, Soma R, Muramoto H, Hayase H, Orito M, Okada T, Mabuchi H, Okino S (2002) Acute urinary retention as an unusual manifestation of aseptic meningitis. Int Med 41:392–394
Abrams P, Cardozo L, Fall M, Grrifiths D, Rosier P, Ulmstein U, van Kerrenbroeck P, Victor A, Wein A (2002) The standardization of terminology of lower urinary tract function; report from the Standardization Subcommittee of the International Continence Society. Neurourol Urodynam 21:167–178
Blaivas JG (1982) The neurophysiology of micturition; a clinical study of 550 patients. J Urol 127:958–963
Elsberg CA (1913) Experiences in spinal surgery: observations upon 60 laminectomies for spinal disease. Surg Gynecol Obstet 16:117–132
Hemrika DJ, Schutte MF, Bleker OP (1986) Elsberg syndrome; a neurologic basis for acute urinary retention in patients with genital herpes. Obstet Gynecol 68:37–39
Lepori P, Marcacci G, Gaglianone S (1992) Elsberg syndrome: radiculomyelopathy and acute urinary retention in patient with genital herpes. Ital J Neurol Sci 13:373–375
Yamanishi T, Yasuda K, Sakakibara R, Hattori T, Uchiyama T, Minamide M, Ito T (1998) Urinary retention due to Herpes Simplex infections. Neurourol Urodynam 17:613–619
Sakakibara R, Hattori T, Yasuda K, Yamanishi T (1996) Micturitional disturbance in acute disseminated encephalomyelitis (ADEM). J Auton Nerv Syst 60:200–205
Alford EC Jr (1985) Disseminated encephalomyelitis; its variations in form and their relationships to other diseases of the nervous system. In: Koetsier JC (ed) Handbook of Clinical Neurology, vol. 3, Demyelinating Disease 467–502
Kesselring J, Miller DH, Robb SA, Kendall BE, Moseley IF, Kingsley D, du Boulay GH, McDonald WI (1990) Acute disseminated encephalomyelitis; MRI findings and the distinction from multiple sclerosis. Brain 113:291–302
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sakakibara, R., Uchiyama, T., Liu, Z. et al. Meningitis–retention syndrome. J Neurol 252, 1495–1499 (2005). https://doi.org/10.1007/s00415-005-0897-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00415-005-0897-6