A case of urinary retention in the early stages of herpes simplex virus type-1 encephalitis

Severe presentation of antibody-negative, postinfectious steroid-responsive encephalitis and atonic bladder after herpes simplex encephalitis

“…With lack of brainstem deficits, back pain, long track signs, sensorimotor or reflex findings to suggest pontine micturition centre, spinal cord, cauda equina or peripheral nerve involvement, our case is suggestive of a previous hypothesis of preferential parasympathetic pelvic nerve involvement in HSE. Like previous reports,22 resolution was documented in our case as well. Since most patients in the early phases of HSE require bladder catheterisation due to disturbances in consciousness, bladder involvement in HSE may be under-reported, requiring larger scale studies to confirm and characterise such an association.…”

“…HSE has rarely been reported to have associated urinary retention, with onset from 5 days to 2 months. In these reports, HSE-associated urinary retention occurred in the setting of concomitant myeloradiculitis, encephalomyeloradiculitis, acute disseminated encephalomyelitis or herpetic brainstem encephalitis 22–25. With lack of brainstem deficits, back pain, long track signs, sensorimotor or reflex findings to suggest pontine micturition centre, spinal cord, cauda equina or peripheral nerve involvement, our case is suggestive of a previous hypothesis of preferential parasympathetic pelvic nerve involvement in HSE.…”