Meningitis-retention syndrome with reference to mild cases

Abstract

Physicians might encounter patients with acute urinary retention due to benign inflammatory nervous diseases. Based on the mechanism of urinary retention, these disorders can be divided into two subgroups: disorders of the peripheral nervous system (e.g., sacral herpes with skin rash) or the central nervous system (e.g., meningitis-retention syndrome [MRS] with mild pyramidal signs). Laboratory abnormalities include positive herpes virus PCR, and increased myelin basic protein/ oligoclonal band in the cerebrospinal fluid (CSF) in MRS. Acute urodynamic abnormality in both conditions is detrusor underactivity, while in MRS detrusor overactivity might follow, indicating selective involvement of the spinal descending tract to the bladder (acute shock phase) in MRS that might affect the thoracic spinal cord. There are few cases with CSF abnormality alone, including ours. Management of the acute urinary retention is necessary to avoid bladder injury due to overdistension.