Fahr Syndrome Unknown Complication: Overactive Bladder

Abstract

A 38-year-old male patient was admitted to our outpatient department because of frequency and urgency incontinence. During evaluation it was detected that the patient was suffering from frequency which was progressive for one year, feeling of incontinence, and urgency incontinence. There was no urologic pathology detected in patient's medical and family history. Neurologic consultation was requested due to his history of boredom, reluctance to do business, balance disorders, and recession for about 3 years. Brain computerized tomography (CT) scan revealed that amorphous calcifications were detected in the bilaterally centrum semiovale, basal ganglia, capsula interna, thalami, mesencephalon, pons and bulbus, and the bilateral cerebellar hemispheres. We have detected spontaneous neurogenic detrusor overactivity without sphincter dyssynergia after evaluating the voiding diary, cystometry, and pressure flow study. We consider the detrusor overactivity which occurred one year after the start of the neurological symptoms as the suprapontine inhibition and damage in the axonal pathways in the Fahr syndrome.

Fahr Syndrome – an Important Piece of a Puzzle in the Differential Diagnosis of Many Diseases

“…Psychiatric symptomatology typically includes cognitive impairment, schizophrenia-like psychosis, hallucinations, delusions, anxiety, mania, depression, hyposchemazia as well as personality changes [ 35 – 38 ]. Headache, vertigo, stroke-like events, orthostatic hypotension, dysarthria, paresis, overactive bladder and syncope of unknown etiology have also been reported [ 39 – 41 ]. In children, Fahr’s syndrome may take the form of severe encephalopathy with dwarfism, microcephaly and optic nerve atrophy [ 28 ].…”

Subinguinal Varicocelectomy Under Spinal Anesthesia in a Fahr's Syndrome Patient with Non-Obstructive Azoospermia

“…Fahr's syndrome is a rare disease that was identified by Fahr in 1930 for the first time, depending on calcium and phosphorus metabolism disorder, characterized by double sided, symmetrical intracranial calcification [1]. Although its clinical findings are parkinsonism, dystonia, tremor, chorea, dementia and mood disorders, it can occur with urological symptoms such as overactive bladder [2][3]. Previously, operation under general anesthesia in a Fahr's syndrome patient was reported in the literature [4].…”