TY - JOUR
T1 - Prevalence and mechanism of bladder dysfunction in Guillain-Barré syndrome
AU - Sakakibara, Ryuji
AU - Uchiyama, Tomoyuki
AU - Kuwabara, Satoshi
AU - Mori, Masahiro
AU - Ito, Takashi
AU - Yamamoto, Tatsuya
AU - Awa, Yusuke
AU - Yamaguchi, Chiharu
AU - Yuki, Nobuhiro
AU - Vernino, Steven
AU - Kishi, Masahiko
AU - Shirai, Kohji
PY - 2009
Y1 - 2009
N2 - Aim: To examine the prevalence and mechanism of urinary dysfunction in GBS. Methods: Urinary symptoms were observed and neurological examinations made repeatedly during hospitalization of 65 consecutive patients with clinico-neurophysiologically definite GBS. The patients included 41 men, 24 women; mean age, 41 years old; mean Hughes motor grade, 3; AIDP, 28, AMAN, 37. Urodynamic studies consisted of uroflowmetry, measurement of post-micturition residuals, medium-fill water cystometry, and external anal sphincter electromyography. Results: Urinary dysfunction was observed in 27.7% of GBS cases (urinary retention, 9.2%). Urinary dysfunction was related to the Hughes motor grade (P < 0.05), defecatory dysfunction (P < 0.05), age (P < 0.05), and negatively related to serum IgG class anti-ganglioside antibody GalNAc-GD1a (P < 0.05). Urinary dysfunction was more common in AIDP (39%) than in AMAN (19%). No association was found between antibody titer against neuronal nicotinic acetylcholine receptors and urinary dysfunction. Urodynamic studies in nine patients, mostly performed within 8 weeks after disease onset, revealed post-void residual in 3 (mean 195 ml), among those who were able to urinate; decreased bladder sensation in 1; detrusor overactivity in 8; low compliance in 1; underactive detrusor in 7 (both overactive and underactive detrusor in 5); and nonrelaxing sphincter in 2. Conclusion: In our series of GBS cases, 27.7% of the patients had urinary dysfunction, including urinary retention in 9.2%. Underactive detrusor, overactive detrusor, and to a lesser extent, hyperactive sphincter are the major urodynamic abnormalities. The underlying mechanisms of urinary dysfunction appear to involve both hypo- and hyperactive lumbosacral nerves.
AB - Aim: To examine the prevalence and mechanism of urinary dysfunction in GBS. Methods: Urinary symptoms were observed and neurological examinations made repeatedly during hospitalization of 65 consecutive patients with clinico-neurophysiologically definite GBS. The patients included 41 men, 24 women; mean age, 41 years old; mean Hughes motor grade, 3; AIDP, 28, AMAN, 37. Urodynamic studies consisted of uroflowmetry, measurement of post-micturition residuals, medium-fill water cystometry, and external anal sphincter electromyography. Results: Urinary dysfunction was observed in 27.7% of GBS cases (urinary retention, 9.2%). Urinary dysfunction was related to the Hughes motor grade (P < 0.05), defecatory dysfunction (P < 0.05), age (P < 0.05), and negatively related to serum IgG class anti-ganglioside antibody GalNAc-GD1a (P < 0.05). Urinary dysfunction was more common in AIDP (39%) than in AMAN (19%). No association was found between antibody titer against neuronal nicotinic acetylcholine receptors and urinary dysfunction. Urodynamic studies in nine patients, mostly performed within 8 weeks after disease onset, revealed post-void residual in 3 (mean 195 ml), among those who were able to urinate; decreased bladder sensation in 1; detrusor overactivity in 8; low compliance in 1; underactive detrusor in 7 (both overactive and underactive detrusor in 5); and nonrelaxing sphincter in 2. Conclusion: In our series of GBS cases, 27.7% of the patients had urinary dysfunction, including urinary retention in 9.2%. Underactive detrusor, overactive detrusor, and to a lesser extent, hyperactive sphincter are the major urodynamic abnormalities. The underlying mechanisms of urinary dysfunction appear to involve both hypo- and hyperactive lumbosacral nerves.
KW - Acute inflammatory demyelinating polyneuropathy
KW - Acute motor axonal neuropathy
KW - Autonomic dysfunction
KW - Bladder dysfunction
KW - Guillain-Barré syndrome
UR - http://www.scopus.com/inward/record.url?scp=67649977537&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67649977537&partnerID=8YFLogxK
U2 - 10.1002/nau.20663
DO - 10.1002/nau.20663
M3 - Article
C2 - 19260087
AN - SCOPUS:67649977537
SN - 0733-2467
VL - 28
SP - 432
EP - 437
JO - Neurourology and urodynamics
JF - Neurourology and urodynamics
IS - 5
ER -