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A Journal on Pediatrics, Neonatology, Adolescent Medicine,
Child and Adolescent Psychiatry

Indexed/Abstracted in: CAB, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,532

Frequency: Bi-Monthly

ISSN 0026-4946

Online ISSN 1827-1715


Minerva Pediatrica 2006 June;58(3):305-9


Acute urinary retention in a child with acute disseminated encephalomyelitis

Doria Lamba L. 1, De Grandis E. 1, De Negri E. 1, Montaldi L. 1, Grosso P. 1, Marazzi M. G. 2, Rossi A. 3, Tuo P. 4

1 Unità Operativa di Neuropsichiatria Infantile Dipartimento di Neuroscienze Oftalmologia e Genetica Sezione di Neuroscienze dello Sviluppo Istituto G. Gaslini Università degli Studi di Genova, Genova
2 Unità Operativa Malattie Infettive Dipartimento di Pediatria Istituto G. Gaslini Università degli Studi di Genova, Genova
3 Servizio di Neuroradiologia Istituto G. Gaslini, Genova
4 Unità Terapia Intensiva Istituto G. Gaslini, Genova

Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory demyelinating encephalomyelitis with often monosymptomatic abrupt onset, followed by multifocal neurologic symptomatology depending on lesion-site. Diagnosis is made on the basis of characteristic magnetic resonance imaging (MRI) signal alterations. ADEM is sensitive to steroid therapy, immunoglobulins and plasmapheresis, presents usually a monophasic course and disappears completely after 2 or 3 weeks. Resolution of MRI lesions appears usually within 6 months of presentation. We report on a 14-year-old male, admitted to our Emergency Unit because of fever and acute urinary retention with a normal neurological examination. Urinary tract ultrasonography and mictional cystography were normal; electrophysiology showed a mild involvement of the peripheral nervous system and brain and spine MRI revealed disseminated areas of increased signal on T2-weighted sequences suggestive of ADEM. Steroid therapy brought about clinical recovery in a few days. Resolution of lesions on MRI after 4 months and absence of relapses during four-year clinical follow-up confirmed definitive diagnosis. Our case is interesting because, to our knowledge, this is the first literature report with acute urinary retention as predominant symptom in monosymptomatic forms. Another peculiar feature is the absence of associated neurologic symptomatology despite MRI evidence of important brain and spine alterations.

language: Italian


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