Neurology, Internal Medicine, Toho University, Sakura Medical Centre, Sakura, Chiba, Japan
Neurology, Internal Medicine, Toho University, Sakura Medical Centre, Sakura, Chiba, Japan.
BMJ Case Rep. 2020 Nov 17;13(11):e236625. doi: 10.1136/bcr-2020-236625.
We report the case of a 70-year-old Japanese man who was referred from a local urologist because of acute urinary retention (detrusor underactivity revealed by a urodynamics examination). A neurogenic urinary retention workup failed to reveal the aetiology, but a spinal tap incidentally showed occult meningeal reaction with positive oligoclonal band. The patient had no headache, nausea/vomiting or fever. Considering his clinical laboratory findings, his neural lesions seemed to involve the meninges and spinal cord, suggestive of form fruste' meningitis-retention syndrome. When clinicians encounter patients with urinary retention of undetermined aetiology, a spinal tap should be considered.
我们报告了一例 70 岁日本男性病例,因急性尿潴留(尿动力学检查显示逼尿肌功能低下)被当地泌尿科医生转介。神经源性尿潴留检查未能确定病因,但腰椎穿刺意外显示脑膜有隐匿性反应,寡克隆带阳性。患者无头痛、恶心/呕吐或发热。考虑到他的临床实验室检查结果,他的神经病变似乎涉及脑膜和脊髓,提示为“顿挫型”脑膜炎-潴留综合征。当临床医生遇到病因不明的尿潴留患者时,应考虑进行腰椎穿刺。