Department of Pediatric and Public Health Sciences, Regina Margherita Children's Hospital, Postgraduate School of Pediatrics, University of Turin, Piazza Polonia 64, Turin, Italy.
Department of Pediatric and Public Health Sciences, Infectious Diseases Unit, Regina Margherita Children's Hospital, Turin, Italy.
Neurol Sci. 2023 Jun;44(6):1949-1957. doi: 10.1007/s10072-023-06704-0. Epub 2023 Mar 3.
We summarized the clinical and radiological characteristics of meningitis-retention syndrome (MRS), its therapeutic options, and urological outcome, to better understand the pathogenesis of this syndrome and to evaluate the effectiveness of corticosteroids in reducing the period of urinary retention.
We reported a new case of MRS in a male adolescent. We also reviewed the previously 28 reported cases of MRS, collected from inception up to September 2022.
MRS is characterized by aseptic meningitis and urinary retention. The mean length of the interval between the onset of the neurological signs and the urinary retention was 6.4 days. In most cases, no pathogens were isolated in cerebrospinal fluid, except for 6 cases in which Herpesviruses were detected. The urodynamic study resulted in a detrusor underactivity, with a mean period for urination recovery of 4.5 weeks, regardless of therapies.
Neurophysiological studies and electromyographic examination are not pathological, distinguishing MRS from polyneuropathies. Although there are no encephalitic symptoms or signs, and the magnetic resonance is often normal, MRS may represent a mild form of acute disseminated encephalomyelitis, without radiological detectable medullary involvement, due to the prompt use of steroids. It is believed that MRS is a self-limited disease, and no evidence suggests the effectiveness of steroids, antibiotics, and antiviral treatment in its clinical course.
我们总结了脑膜炎伴尿潴留综合征（MRS）的临床和影像学特征、治疗选择和泌尿系统结局，以更好地了解该综合征的发病机制，并评估皮质类固醇在减少尿潴留持续时间方面的有效性。
我们报告了一名男性青少年 MRS 的新病例，并回顾了截至 2022 年 9 月之前从发病开始共 28 例 MRS 的报道病例。
MRS 的特征是无菌性脑膜炎伴尿潴留。神经系统症状和尿潴留之间的平均间隔时间为 6.4 天。除 6 例检测到疱疹病毒外，大多数情况下脑脊液中未分离出病原体。尿动力学研究结果显示逼尿肌活动不足，排尿恢复的平均时间为 4.5 周，无论治疗如何。
神经生理学研究和肌电图检查无异常，将 MRS 与多发性神经病区分开来。尽管没有脑炎症状或体征，且磁共振通常正常，但由于及时使用皮质类固醇，MRS 可能代表一种轻微的急性播散性脑脊髓炎形式，没有影像学可检测到的骨髓受累。据信，MRS 是一种自限性疾病，没有证据表明皮质类固醇、抗生素和抗病毒治疗对其病程有效。
