Meningitis-retention syndrome
| Meningitis-retention syndrome | |
|---|---|
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| Specialty | Uro-neurology |
Meningitis-retention syndrome (MRS) a combination of acute aseptic meningitis and urinary retention (detrusor underactivity) an inflammatory neurological condition that was first described in 2005.[1][2][3][4] Its prevalence as yet remains unknown.
Presentation
[edit]MRS occurs in any age, clinically MRS is defined as a combination of a) aseptic meningitis (increased reflexes without leg weakness might be seen; abnormal cerebrospinal fluid alone can also accompany[5]) and b) acute urinary retention. Aseptic meningitis is a common condition, which is caused by many viruses but also from autoimmune etiologies. MRS occurs in 8% of aseptic meningitis cases. Average latencies from the onset of meningeal irritation to urinary symptoms were 0–8 days. However, in some cases, urinary retention precedes fever and headache. The duration of urinary retention in MRS was mostly 7–14 days, lasting up to 10 weeks. Mild acute disseminated encephalomyelitis (ADEM) is considered an underlying mechanism of MRS, because some patients show elevated myelin basic protein in the CSF and a reversible splenial lesion on brain magnetic resonance imaging .[6]
Cause
[edit]As it is observed in ADEM, antecedent/ comorbid infections or conditions with MRS include Epstein–Barr virus, herpes simplex virus, varicella-zoster virus, West Nile virus, listeria, etc. In addition to these, elevated CSF adenosine deaminase (ADA) levels or decreased CSF/serum glucose ratio may be predictive factors for MRS development.[1]
Diagnosis
[edit]Urodynamic testing including cystometry show that all patients examined had underactive bladder/detrusor underactivity when on retention. Repeated urodynamics showed that underactive detrusor changed to overactive after a 4-month period, suggesting an upper motor neuron bladder dysfunction (possible spinal shock). MRS should be differentiated from genital herpes (herpes simplex virus,[7][8] varicella-zoster virus[9][10]) and so-called Elsberg syndrome.[11] Clinical/pathological features of Elsberg syndrome were: rare CSF abnormalities; no clinical meningitis; a subacute/chronic course; presentation with typical cauda equina motor-sensory-autonomic syndrome; Wallerian degeneration of the spinal afferent tracts; and mild upper motor neuron signs. All these are different from those of MRS.[12][13][14][15]
Treatment
[edit]It is believed that MRS is a self-limited disease, the duration of urinary retention in MRS was mostly 7–14 days, lasting up to 10 weeks. While urinary retention in MRS ameliorates in most cases, care must be taken to prevent overdistension bladder injury, by performing clean-intermittent self-catheterization. It is not known whether steroid pulse therapy might shorten the period of urinary retention, because of MRS's self-remitting feature.[16][17]
History
[edit]This disease was described first by Sakakibara R et al. in 2005.[1]
See also
[edit]- Neurogenic bladder dysfunction
- Aseptic meningitis
- Autonomic nervous system
- Autonomic failure,dysautonomia
- Multiple sclerosis
- Spinal cord
- Nerve root
- Urinary retention
- Fowler's syndrome
- International Continence Society
References
[edit]- ^ a b c Sakakibara R, Uchiyama T, Liu Z, Yamamoto T, Ito T, Uzawa A (2005). "Meningitis-retention syndrome; an unrecognized clinical condition". J Neurol. 252 (12): 1495–1499. doi:10.1007/s00415-005-0897-6. PMID 16021353.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Sakakibara R, Kishi M, Tsuyusaki Y, Tateno A, Tateno F, Uchiyama T, Yamamoto T, Yamanishi T, Yano M (2013). ""Meningitis-retention syndrome": a review". Neurourol Urodyn. 32 (1): 19–23. doi:10.1002/nau.22279. PMID 22674777.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Hiraga A, Kuwabara S (2018). "Meningitis-retention syndrome: Clinical features, frequency and prognosis". J Neurol Sci. 390: 261–264. doi:10.1016/j.jns.2018.05.008. PMID 29801901.
- ^ Sakakibara R (2019). "Neurogenic lower urinary tract dysfunction in multiple sclerosis, neuromyelitis optica, and related disorders". Clin Auton Res. 29 (3): 313–320. doi:10.1007/s10286-018-0551-x. PMID 30076494.
- ^ Sakakibara R, Sakai D, Tateno F, Aiba Y. (2020). "Urinary retention with occult meningeal reaction: a 'form fruste' meningitis-retention syndrome". BMJ Case Rep. 13(11): e236625 (11): e236625. doi:10.1136/bcr-2020-236625. PMC 7674081. PMID 33203783.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Tascilar N, Aydemir H, Emre U, Unal A, Atasoy HT, Ekem S. (2009). "Unusual combination of reversible splenial lesion and meningitis-retention syndrome in aseptic meningomyelitis". Clinics (Sao Paulo). 64 (9): 932–937. doi:10.1590/S1807-59322009000900017. PMC 2745142. PMID 19759890.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Sakakibara R, Yamanishi T, Uchiyama T, Hattori T. (2006). "Acute urinary retention due to benign inflammatory nervous diseases". J Neurol. 253 (8): 1103–1110. doi:10.1007/s00415-006-0189-9. PMID 16680560.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Fowler C. (2006). "Short Commentary on "Acute urinary retention due to benign inflammatory nervous diseases" by Sakakibara et al. in J Neurol (2006) 253:1103-1110". J Neurol. 253 (8): 1102. doi:10.1007/s00415-006-0188-x. PMID 16906345.
- ^ Hadžavdić SL, Kovačević M, Skerlev M, Zekan S. (2018). "Genital Herpes Zoster as Possible Indicator of HIV Infection". Acta Dermatovenerol Croat. 26 (4): 337–338. PMID 30665486.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Sakakibara R, Sawai S, Ogata T. (2022). "Varicella-zoster virus infection and autonomic dysfunction". Auton Neurosci. 242:103018. doi:10.1016/j.autneu.2022.103018. PMID 35863181.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Kennedy F, Elsberg CA, Lambert CI. (1913). "A peculiar undescribed disease of the nerves of the cauda equina". Am J Med Sci. 147 (5): 645–647. doi:10.1097/00000441-191405000-00003.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Gheewala GK, Surana DU, Patel A, Daruwala F. (2024). "Meningitis-Retention Syndrome as an Unrecognized Clinical Condition in Indian Scenario: Fall Through the Cracks". Cureus. 16(2):e54910 (2): e54910. doi:10.7759/cureus.54910. PMC 10966420. PMID 38544590.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Wang CH, Huang CN, Wang PW. (2023). "A 10-year-old girl with meningitis retention syndrome and reversible splenial lesion: A case report". Pediatr Neonatol. S1875-9572(23)00202-4 (2): 204–206. doi:10.1016/j.pedneo.2023.08.007. PMID 37951830.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Nagano T, Hosokawa S, Miyahara H, Yamada K, Umeno T, Kano H, Kayatani H, Sakugawa M, Takehisa Y, Takenaka T, Takeuchi M, Bessho A.. (2023). "Urinary Retention Suggesting Aseptic Meningitis: Meningitis-Retention Syndrome Without Physical Signs of Meningeal Irritation". Acta Med Okayama. 77 (2): 199–201. doi:10.18926/AMO/65150. PMID 37094958.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Hidaka M, Sawamura N, Yokoi M, Mezuki S, Osaki M, Arakawa S, Akiyama T, Yamaguchi S, Sayama T, Kitazono T. (2021). "Meningitis retention syndrome associated with complicated mild encephalitis/encephalopathy with reversible splenial lesion in a young adult patient: a case report". Oxf Med Case Reports. 2021(10):omab092 (10): omab092. doi:10.1093/omcr/omab092. PMC 8557460. PMID 34729191.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Suzuki M, Watanabe G, Watari T. (2020). "Epstein-Barr Virus-induced Meningitis-Retention Syndrome". Eur J Case Rep Intern Med. 7(12):002133 (12): 002133. doi:10.12890/2020_002133. PMC 7806303. PMID 33457375.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Pellegrino, Francesco; Funiciello, Elisa; Pruccoli, Giulia; Silvestro, Erika; Scolfaro, Carlo; Mignone, Federica; Tocchet, Aba; Roasio, Luca; Garazzino, Silvia (June 2023). "Meningitis-retention syndrome: a review and update of an unrecognized clinical condition". Neurological Sciences. 44 (6): 1949–1957. doi:10.1007/s10072-023-06704-0. ISSN 1590-3478. PMC 10175389. PMID 36867276.