Houang M, Leroy B, Forin V, Sinnassamy P, Bensman A
Service de néphrologie pédiatrique, hôpital Trousseau, Paris, France.
Arch Pediatr. 1994 Mar;1(3):260-3.
Syringomyelia is rare in children aged less than 10 years, and bladder dysfunction is an unlikely first manifestation. This report describes a case of repeated episodes of acute urinary retention in a young girl revealing syringomyelia and Arnold-Chiari malformation.
A 2.5 year-old girl was admitted because she was suffering from acute urinary retention. Her poor appetite had been treated with cyproheptadine, a histamine type I blocking drug. Clinical investigation revealed no local cause for this bladder dysfunction except moderate spasticity of the legs. Cystography showed no vesicoureteral reflux. Because the episodes of urinary retention recurred each day, magnetic resonance imaging (MRI) was performed; this showed the typical features of syringomyelia extending from C5 to T11 plus Arnold-Chiari malformation. The cyproheptadine was discontinued and the urinary retention disappeared.
Cyproheptadine may have revealed latent neurogenic bladder in this case, although urodynamic studies, performed 3 months later, detected no bladder dysfunction.
脊髓空洞症在10岁以下儿童中较为罕见，膀胱功能障碍不太可能是其首发表现。本报告描述了一名年轻女孩反复出现急性尿潴留的病例，该病例揭示了脊髓空洞症和阿诺德 - 基亚里畸形。
一名2.5岁女孩因急性尿潴留入院。她的食欲不振曾用赛庚啶（一种I型组胺阻断药物）治疗。临床检查除腿部中度痉挛外，未发现导致这种膀胱功能障碍的局部原因。膀胱造影显示无膀胱输尿管反流。由于尿潴留每天复发，遂进行了磁共振成像（MRI）检查；结果显示脊髓空洞症的典型特征，范围从C5延伸至T11，同时伴有阿诺德 - 基亚里畸形。停用赛庚啶后，尿潴留消失。
在本病例中，赛庚啶可能揭示了潜在的神经源性膀胱，尽管3个月后进行的尿动力学研究未检测到膀胱功能障碍。
