Neurogenic bladder may be a side effect of focus resection in an epileptic patient.
A 34-year-old man with intractable epilepsy was treated by focus resection. The resected volume of neocortex in the left supracallosal part of the medial frontal gyrus was 7 x 1 x 2.5 cm. The treatment was effective and epileptic attacks completely disappeared. However, the patient developed urinary incontinence postoperatively without any other new neurological abnormalities. Urodynamic study revealed loss of bladder sensation, increased bladder capacity, involuntary detrusor contraction, and synergic external sphincter. The suprcallosal part of the medial frontal gyrus has been reported to include 1 of the suprapontine micturition centers. In this case, resection of this area significantly affected bladder function. Loss of bladder sensation and increased threshold volume on micturition are characteristic signs of deficit in this area.
Sekido
N
N
Department of Urology, University of Tsukuba, Japan.
Akaza
H
H
D000328:Adult; D004827:Epilepsy / Q000601:surgery*; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011183:Postoperative Complications; D012678:Sensation Disorders / Q000209:etiology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D001743:Urinary Bladder / Q000503:physiopathology; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000209:etiology* / Q000503:physiopathology; D014563:Urodynamics