Urodynamic findings in patients with Creutzfeldt-Jakob disease: a case report.
OBJECTIVE
Urinary dysfunction in Creutzfeldt-Jakob disease (CJD) patients is attributed to functional incontinence, since they often have immobility and loss of motivation. In contrast, previously no urodynamic findings are available in CJD patients.


METHODS
We had 2 CJD patients who had urinary frequency and urinary retention. We performed urodynamics with the spouse's informed consent in order to explore the mechanism of urinary dysfunction in those cases. Case 1 had typical acute cognitive deterioration with incontinence and urinary retention, while case 2 had subacute cognitive deterioration (that started after admission) and nocturia. The urodynamic findings were diverse. One feature was detrusor overactivity during bladder filling in case 1. Another feature of urodynamic finding includes neurogenic change of sphincter EMG in case 1 and decreased bladder sensation in case 2.


CONCLUSIONS
Urodynamics in our two CJD patients revealed detrusor overactivity and neurogenic sphincter electromyogram, presumably reflecting pathological lesions in the prefrontal cortex/basal ganglia as well as the sacral spinal cord in CJD.
Urology, Toho University Sakura Medical Center, Sakura, Japan.
Masashi
M
Yano
Neurology, Internal Medicine, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, 285-8741, Japan. sakakibara@sakura.med.toho-u.ac.jp.
Ryuji
http://orcid.org/0000-0002-5803-169X
R
Sakakibara
Neurology, Internal Medicine, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, 285-8741, Japan.
Fuyuki
F
Tateno
Clinical Physiology Unit, Toho University Sakura Medical Center, Sakura, Japan.
Osamu
O
Takahashi
Clinical Physiology Unit, Toho University Sakura Medical Center, Sakura, Japan.
Haruka
H
Nakamura
Clinical Physiology Unit, Toho University Sakura Medical Center, Sakura, Japan.
Megumi
M
Sugiyama
Urology, Toho University Sakura Medical Center, Sakura, Japan.
Lee
L
Fang-Ching
Urology, Toho University Sakura Medical Center, Sakura, Japan.
Syuichi
S
Kamijima
Urology, Toho University Sakura Medical Center, Sakura, Japan.
Naoto
N
Kamiya
Urology, Toho University Sakura Medical Center, Sakura, Japan.
Hiroyoshi
H
Suzuki
D000368:Aged; D007562:Creutzfeldt-Jakob Syndrome / Q000150:complications / Q000175:diagnosis; D003950:Diagnostic Techniques, Urological; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D009460:Neurologic Examination / Q000379:methods; D063189:Symptom Assessment / Q000379:methods; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D014546:Urinary Catheterization / Q000379:methods*; D014549:Urinary Incontinence / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D016055:Urinary Retention / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D014563:Urodynamics
Creutzfeldt–Jakob disease; Detrusor overactivity; Sphincter electromyography; Urinary dysfunction