title: 4-aminopyridine improves lower urinary tract symptoms in a patient with benign prostatic hyperplasia and downbeat nystagmus syndrome.
abstract: Aminopyridines are potassium channel blockers that increase the excitability of nerve cells and axons; therefore, they are widely used to treat different neurological disorders. Here we present a patient with idiopathic downbeat nystagmus and lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia who was treated with the sustained-release form of 4-aminopyridine (4-AP). During treatment with 4-AP, the LUTS improved. This improvement was monitored by using uroflowmetry and the International Prostate Symptom Score. A significant improvement of symptoms was observed in relation to the voided volume. This included an improved emptying of the bladder without an increase in residual urine. In animal studies, both nonselective K(+) channel blockade and selective voltage-sensitive potassium blockade by 4-AP resulted in increased contraction on rat detrusor strips. To our knowledge, this is the first clinical observation of the mode of action of 4-AP in urological symptoms in humans.
authors.affiliation: Department of Neurology, University Hospital Munich, Campus Grosshadern, Munich, Germany. ; German Center for Vertigo and Balance Disorders, University Hospital Munich, Campus Grosshadern, Munich, Germany.
authors.forename: Michael
authors.identifier: 0000-0002-9544-2279
authors.initials: M
authors.lastname: Strupp
authors.affiliation: Department of Neurology, University Hospital Munich, Campus Grosshadern, Munich, Germany. ; German Center for Vertigo and Balance Disorders, University Hospital Munich, Campus Grosshadern, Munich, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Feil
authors.affiliation: German Center for Vertigo and Balance Disorders, University Hospital Munich, Campus Grosshadern, Munich, Germany.
authors.forename: Stanislavs
authors.initials: S
authors.lastname: Bardins
authors.affiliation: Department of Urology, University Hospital Munich, Campus Grosshadern, Munich, Germany.
authors.forename: Raphaela
authors.initials: R
authors.lastname: Waidelich
keywords: 4-Aminopyridine; Drug Therapy; Lower Urinary Tract Symptoms; Neurogenic Urinary Bladder; Prostatic Hyperplasia