[Neurogenic bladder in children with acute transverse myelopathy].
BACKGROUND
Neurogenic sphincter dysfunction may result from acute transverse myelopathy. The aim of this paper is to study the course of such a dysfunction and to propose management techniques.


METHODS
The files of 21 children admitted at the mean age of 8 years 5 months (2 to 14 years, 8 months) for acute transverse myelopathy were retrospectively studied.


RESULTS
Bladder sphincter dysfunction occurred in the first days of disease in 85% of these patients. Abnormal perception of micturition was one of the most constant and specific symptoms. Anorectal function was also impaired. Complete regressive course was noted in 38% of patients, minor sequellae in 39% and major sequellae beyond 6 months of course in 23%. None upper tract deterioration was noted after 3 years of course. Factors of favorable prognosis were early motor function recovery (especially recommencement of walking before 20 days) and early management of bladder dysfunction (inability to void had better prognosis than urinary incontinence).


CONCLUSIONS
Early systematic bladder drainage in case of inability to void might be essential for improved prognosis.
Service de neuropédiatrie, hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
V
V
Leroy-Malherbe
G
G
Sébire
H
H
Hollenberg
M
M
Tardieu
P
P
Landrieu
D000208:Acute Disease; D000293:Adolescent; D001003:Anal Canal; D002648:Child; D002675:Child, Preschool; D003663:Decision Trees; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009188:Myelitis, Transverse / Q000150:complications*; D012189:Retrospective Studies; D001750:Urinary Bladder, Neurogenic / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy
Troubles sphinctériens de la myélopathie aiguë transverse de l'enfant. Aspects diagnostiques, pronostiques, rééducatifs.