Urodynamic and neurophysiologic evaluation of patients with diastematomyelia.
Diastematomyelia is a form of an occult dysraphism, which can present with lower urinary tract dysfunction. We present the findings in 21 patients with diastematomyelia evaluated at the Children's Hospital in Boston. Seventy-six percent of the patients were female. Eighty-six per cent had a cutaneous lesion present overlying the spine. Urodynamic and electrophysiologic studies showed abnormalities in 17 (81%) of 21 patients, of whom 13 (62%) had upper motor neuron dysfunction. Seventeen patients underwent corrective spinal surgery and none of the patients deteriorated on a follow-up urodynamic and electrophysiologic study. We recommend that patients with cutaneous, midline lower back lesions with or without lower urinary tract dysfunction be evaluated with a urodynamic and electrophysiologic study to characterize the extent of neurologic and urologic dysfunction.
Kothari
M J
MJ
Division of Neurology, Pennsylvania State University College of Medicine, Hershey 17033, USA.
Bauer
S B
SB
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004594:Electrophysiology; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D012447:Sacrum / Q000002:abnormalities / Q000473:pathology*; D016136:Spina Bifida Occulta / Q000175:diagnosis* / Q000503:physiopathology; D014551:Urinary Tract / Q000294:innervation / Q000503:physiopathology*; D014563:Urodynamics; D014570:Urologic Diseases / Q000175:diagnosis* / Q000503:physiopathology