Micturition Disturbance: A Predominant Feature of Acute Disseminated Encephalomyelitis

Abstract

Urinary retention in children can have varied etiology ranging from anatomic to functional causes. Functional causes include neuropathies, including rare central nervous system (CNS) involvement, such as acute disseminated encephalomyelitis (ADEM). ADEM is usually preceded by acute viral infection and commonly presents with multifocal neurological deficits. The ADEM diagnosis is mainly based on the clinical presentation and its correlation with characteristic CNS findings on magnetic resonance imaging (MRI). Here, we report an adolescent boy who presented with acute urinary retention preceded by an acute febrile illness. The patient was worked up thoroughly, including an MRI of the brain and spine, which revealed ADEM's characteristic features. The bladder function was evaluated periodically. The voiding dysfunction persisted for a long time. Treatment with steroids and other supportive therapy ultimately lead to a complete recovery over 6 months.