A Case of Wernicke's Encephalopathy with Detrusor-sphincter Dyssynergia Masamitsu Yaguchi 1 , Hisa Yaguchi 1 , Chikara Nagaura 2 1Department of Neurology, Shiseido General Hospital 2Department of Urology, Yamagata City Hospital Saiseikan Keyword: ウェルニッケ脳症 , 尿閉 , 尿流動態検査 , 膀胱内圧測定 , 排尿筋外括約筋協調不全 , Wernicke's encephalopathy , urinary retention , urodynamic study , cystmetry , detrusor-sphincter dyssynergia pp.317-321
Published Date 2015/3/1
DOI https://doi.org/10.11477/mf.1416200139
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We report a case of a 54-year-old man with alcoholic Wernicke's encephalopathy. Neurological examination showed unconsciousness, absence of the oculocephalic reflex, generalized hyporeflexia, and urinary retention. The patient immediately regained consciousness after the administration of thiamine, but amnesia and cerebellar ataxia became apparent. The urinary retention persisted, and an urodynamic study showed detrusor-sphincter dyssynergia. Three months after the treatment, the urinary retention resolved, and a second urodynamic study showed disappearance of the detrusor-sphincter dyssynergia. Wernicke's encephalopathy involves the periaqueductal gray matter and the floor of the fourth ventricle. For the voiding reflex, the periaqueductal gray matter neurons project to the pontine micturition center, which seems to be located adjacent to the locus coeruleus. We concluded that lesions of the periaqueductal gray matter and/or the dorsolateral portion of the pons were responsible for the micturitional disturbance in the patient.

(Received July 22, 2014; Accepted September 11, 2014; Published March 1, 2015)

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