Authors: U K Misra J Kalita G Kumar R Kapoor
Publish Date: 2009/01/21
Volume: 255, Issue: 12, Pages: 1881-1888
Abstract
SACD was diagnosed by clinical features and low serum B12 level 211 pg/ml and/or megaloblastic bone marrow Micturition disturbances were categorized into voiding and storage symptoms and scored using the American Urological Association Symptoms AUAS score Spinal MRI and urodynamic studies were carried out Patients were treated with vitamin B12 1000 μg daily im and outcome was defined at 6 months into complete partial and poorEight patients with SACD aged 538 44–70 years were included 2 of whom were females The mean duration of illness was 22 1–120 months All had walking difficulty 2 were wheelchair bound and 4 bedridden Lower limb spasticity and joint position impairment were present in all ankle reflex was absent and pinprick sensation reduced distally in 4 patients each T2 hyperintensity in the posterior spinal cord was present in 5 and in subcortical white matter in 2 patients Five patients had storage 7 voiding and 4 had both dysfunctions AUAS score was 1463 4–35 On urodynamic study detrusor areflexia was present in 2 neurogenic detrusor overactivity with high pressure voiding in 3 and normal in 2 patients The urinary symptoms improved in all AUAS score 367 Repeat urodynamic study in 2 patients who had detrusor areflexia improved At 6 mo 3 patients had complete 4 partial and 1 poor recovery
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