title: [Autonomic nervous system alteration in multiple sclerosis patients with urinary symptoms. Clinical, urodynamic and cardiovascular study].
abstract: OBJECTIVE
  To assess symptoms related to autonomic nervous system alteration in a population of patients suffering from multiple sclerosis (MS) and presenting with urinary symptoms.
  
  
  METHODS
  We investigated 65 patients (mean age 47.5 years) suffering from MS, and presenting with urological dysfunction by means of symptom scores, urodynamic investigation, cardiovascular autonomic function tests (orthostatic hypotension testing, Valsalva test, deep breath test, cold pressor test) and sympathetic skin responses.
  
  
  RESULTS
  Forty-five (69%) patients suffered from overactive bladder, 48 (73%) from voiding dysfunction, 14 (21%) from urinary retention and 13 (20%) from fecal incontinence. Urodynamic investigation demonstrated overactive detrusor in 46 (70%) cases, and underactive detrusor in four (6%) cases. Twenty-five (38%) patients had dysautonomia without correlation neither with clinical or urodynamic data, nor gravity of multiple sclerosis (EDSS).
  
  
  CONCLUSIONS
  In this series, the prevalence of dysautonomia was high in patients suffering from MS and presenting with urinary disorders.
authors.affiliation: GRC 01 UPMC GREEN groupe de recherche clinique en neuro-urologie, service de neuro-urologie et d'explorations périnéales, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France. Electronic address: gerard.amarenco@tnn.aphp.fr.
authors.forename: G
authors.initials: G
authors.lastname: Amarenco
authors.forename: P
authors.initials: P
authors.lastname: Raibaut
authors.forename: K
authors.initials: K
authors.lastname: Hubeaux
authors.forename: M
authors.initials: M
authors.lastname: Jousse
authors.forename: S
authors.initials: S
authors.lastname: Sheikh Ismaël
authors.forename: E
authors.initials: E
authors.lastname: Lapeyre
mesh_terms: D001944:Breath Tests; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D018737:Hand Strength; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D054969:Primary Dysautonomias / Q000175:diagnosis* / Q000209:etiology; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D018667:Tilt-Table Test; D053201:Urinary Bladder, Overactive / Q000209:etiology*; D016055:Urinary Retention / Q000209:etiology*; D014555:Urination Disorders / Q000209:etiology*; D014563:Urodynamics; D014636:Valsalva Maneuver
keywords: Cardiovascular autonomic function test; Dysautonomia; Dysautonomie; Incontinence urinaire; Multiple sclerosis; Sclérose en plaques; Test cardiovasculaire de la fonction autonome; Urinary incontinence; Urodynamic