Severe Peripheral Motor Neuropathy & Urinary Retention: Causes & Reasons

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Patient File

Sex unknown, Age unknown

Reported Symptoms

Severe Peripheral Motor Neuropathy, Urinary Retention,

Negated

None

Unsure

None

Possible Causes

Autonomic Neuropathy

[…] and autonomic neuropathy. [ncbi.nlm.nih.gov]

Four patients had urinary retention and two had voiding difficulty as the initial presentation. [ncbi.nlm.nih.gov]

Signs and symptoms[edit] The signs and symptoms of autonomic neuropathy include the following:[citation needed] Urinary bladder conditions: bladder incontinence or urinary [en.wikipedia.org]

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Diabetic Autonomic Neuropathy

Diabetic autonomic neuropathy is a subgroup of diabetic neuropathy, a group of nerve diseases affecting the peripheral nerves outside the brain and spinal cord. [columbianeurology.org]

[…] incontinence, Urinary retention Exercise Intolerance Esophageal dysfunction : Heartburn, Dysphagia for solids Male Sexual Dysfunction : Erectile dysfunction, Decreased libido [diapedia.org]

Signs and symptoms[edit] The signs and symptoms of autonomic neuropathy include the following:[citation needed] Urinary bladder conditions: bladder incontinence or urinary [en.wikipedia.org]

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Acute Intermittent Porphyria

Acute attacks are characterized by severe abdominal pain, vomiting, constipation, hypertension, tachycardia, and bladder dysfunction, presumably due to an autonomic neuropathy [doi.org]

Urinary retention improved within 4 days. Hematin was imported by then from the United States. [ncbi.nlm.nih.gov]

Neurologic symptoms may also develop, including flaccid paralysis, seizures, neuropsychiatric and urinary symptoms such as retention or incontinence and constipation. [doi.org]

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Guillain-Barré Syndrome

Acute Motor Axonal Neuropathy (AMAN) No sensory deficits Associated with epidemics following C. jejuni enteritis. [pedemmorsels.com]

She subsequently developed pandysautonomia that manifested as a tonically dilated pupil, gastrointestinal dysmotility, urinary retention, and profound orthostatic hypotension [ncbi.nlm.nih.gov]

retention, autonomic dysfunction (orthostatic hypotension, paroxysmal hypertension, dysrhythmiasetc.), constipation etc. [youtube.com]

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Acute Hepatic Porphyria

Peripheral motor neuropathy, characterized by muscle weakness which begins in the proximal upper extremities, may also develop. δ-Aminolevulinic acid dehydratase deficiency [invitae.com]

Other symptoms may include (7): nausea vomiting constipation pain in the back, arms and legs muscle weakness (due to the effects on nerves supplying the muscles) urinary retention [content.sciendo.com]

Neuropathy may progress rapidly to give complete paralysis, incontinence or urinary retention, swallowing difficulties and respiratory failure. [journals.sagepub.com]

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Transverse Myelitis

(AMAN, more rapidly evolving and more severe motor deficits, no sensory deficits), acute motor and sensory axonal neuropathy (AMSAN, reported nearly exclusively in adults [jped.elsevier.es]

retention and several episodes of nausea and vomiting. [ncbi.nlm.nih.gov]

A 35 year-old male Caucasian recently returned from the tropics presented to our hospital with urinary retention and acute paraparesis. [ncbi.nlm.nih.gov]

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Acute Pandysautonomia

[…] demyelinating neuropathy motor as well as sensory component and responding to IVIG. [ispub.com]

The only remaining issue is the urinary retention problem. [forum.gbs-cidp.org]

Diagnostic Approach The differential diagnosis of peripheral neuropathy is significantly narrowed by a focused clinical assessment that addresses several key issues ( Figure [aafp.org]

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Acute Disseminated Encephalomyelitis

[…] cases -with ADAM and severe peripheral neuropathy- were treated with combined high-dose methylprednisolone and immunoglobulin, two remained paraplegic, one had motor and [en.wikipedia.org]

retention. [ncbi.nlm.nih.gov]

We describe a 3-year-old girl who presented with fever, weakness in all four limbs, urinary retention, respiratory distress and altered sensorium. [ncbi.nlm.nih.gov]

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Neuropathy

If severely affected, the patient may develop chronic muscle wasting. How is Peripheral Neuropathies Treated? [healthengine.com.au]

Autonomic dysfunction results in lack of sweating, dizziness on standing caused by a drop in blood pressure, delayed gastric emptying, abdominal distension, urinary retention [precisionhealth.com.au]

They are inexpensive but can be associated with several side effects, including dry mouth, blurred vision and urinary retention. [sydneynorthneurology.com.au]

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Porphyria

Acute attacks occur mainly in adults and comprise severe abdominal pain, nausea, vomiting, autonomic disturbance, central nervous system involvement and peripheral motor neuropathy [ncbi.nlm.nih.gov]

retention confusion hallucinations seizures and muscle weakness A health care provider diagnoses porphyria with blood, urine, and stool tests. [web.archive.org]

[…] urine), peripheral neuropathy (patchy numbness and paresthesias), Proximal motor weakness (usually starting in upper extremities which can progress to include respiratory [house.wikia.com]

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Peripheral Neuropathy

We treated a 52-year-old man who had severe disabling classic peripheral neuropathy since 1998 with Scrambler Therapy (Calmare), an FDA-cleared peripheral non-invasive neuromodulation [ncbi.nlm.nih.gov]

Other indicators of autonomic nerve damage are lack of sweat, tears, and saliva; constipation ; urinary retention; and impotence. [medical-dictionary.thefreedictionary.com]

Side effects, which are typically predictable and related to anticholinergic actions, include dry mouth, blurred vision, cardiac arrhythmias, sedation, urinary retention, [clinical.diabetesjournals.org]

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Polyneuropathy

Peripheral sensori-motor neuropathy  Distal, bilateral,symmetrical, stocking-glove distribution.  Symptoms range from numbness (“deadness”) to severe pain. [slideshare.net]

Retention - often responds to cholinergic agents such as bethanechol Gastroparesis Cisapride (Propulsid ) 10-20mg po tid-qid is best tolerated Also responds to erythromycin [enotes.tripod.com]

retention impotence reduced sweating Heart disease (restrictive cardiomyopathy): Amyloid deposits in the heart cause stiffening and thickening of the heart muscle, so the [ttrstudy.com]

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Miller-Fisher Syndrome

In addition to peripheral neuropathy CNS involvement, exclusive or more marked in posterior fossa, occurs not infrequently. [moh-it.pure.elsevier.com]

retention 0 We present the case of a 16 year old boy in acute urinary retention secondary to an inflammatory polyneuropathy; likely the Miller Fisher variant of GBS. [bjuinternational.com]

Autonomic dysfunction was also expressed in the form of transient urinary retention. [ncbi.nlm.nih.gov]

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Renal Function Impairment

peripheral sensory and motor neuropathies, muscle cramps, hyperreflexia, restless legs syndrome, and seizures (usually the result of hypertensive or metabolic encephalopathy [merckmanuals.com]

Common side effects reported with TCAs include postural hypotension and anticholinergic side effects, such as constipation, urinary retention, blurred vision, dry mouth, delirium [the-hospitalist.org]

Anticholinergics (eg, tricyclic antidepressants), and alcohol may cause urinary tract obstruction due to retention of urine in the bladder. [patient.info]

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Diabetic Enteropathy

Peripheral sensori-motor neuropathy  Distal, bilateral,symmetrical, stocking-glove distribution.  Symptoms range from numbness (“deadness”) to severe pain. [slideshare.net]

retention and incontinence gastroparesis nausea & vomiting, early satiety should be evaluated with upper endoscopy to rule out obstructing mass confirm diagnsis with gastric [medbullets.com]

[…] flow rate Bladder overdistension Late features Urinary retention Overflow incontinence Females: Reduced vaginal lubrication Cardiovascular Dysfunction present in 20% of asymptomatic [neuromuscular.wustl.edu]

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Familial Progressive Polyneuropathy

Its severity was proportional to both sensory-motor peripheral neuropathy and dysautonomia. [content.iospress.com]

The symptoms include orthostatic hypotension, constipation alternating with diarrhea, erectile dysfunction, anhydrosis, and urinary retention or incontinence. [dovepress.com]

Diagnostic Approach The differential diagnosis of peripheral neuropathy is significantly narrowed by a focused clinical assessment that addresses several key issues ( Figure [aafp.org]

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Diabetic Neuropathy

Diabetic neuropathy affects all peripheral nerves including sensory neurons, motor neurons, but rarely affects the autonomic nervous system. [en.wikipedia.org]

retention, bladder enlargement, and overflow incontinence. [15,17] Am J Health Syst Pharm. 2004;61(2) 2004 American Society of Health-System Pharmacists [medscape.com]

retention/overflow incontinence Neuropathic oedema Gustatory sweating Anhidrosis (absent sweating) Abnormal pupillary reflexes Treatment Management of autonomic neuropathy [nhshighland.scot.nhs.uk]

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Chronic Kidney Insufficiency

The restless legs syndrome is a manifestation of sensory peripheral neuropathy. Motor neuropathy is a late phenomenon in uremia. [meddean.luc.edu]

Toxic Organ Damage as a Result of Retention of Urinary Excreted Metabolites Toxic organ damage is summarized by the umbrella term uremic syndrome. [lecturio.com]

Heart failure caused by hypertension or coronary artery disease and renal retention of sodium and water may lead to dependent edema and/or dyspnea. [merckmanuals.com]

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Peripheral Neuroblastoma

Peripheral Neuropathy: Severe (Grade 3) peripheral sensory neuropathy occurred in 2 (1%) patients and severe peripheral motor neuropathy occurred in 2 (1%) patients in the [unituxin.com]

Prolonged Urinary Retention: Urinary retention that persists for weeks to months following discontinuation of opioids has occurred in patients treated with Unituxin. [unituxin.com]

Discontinue Unituxin for severe unresponsive pain, severe sensory neuropathy, and moderate to severe peripheral motor neuropathy. [unituxin.com]

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Diabetic Polyneuropathy

Signs and symptoms [ edit ] Illustration depicting areas affected by diabetic neuropathy Diabetic neuropathy affects all peripheral nerves including sensory neurons, motor [en.wikipedia.org]

[…] alpha one receptors Cymbalta (Duloxetine) equal affinity for 5HT and NE – primarily related to Anti-ACh actions: dry mouth blurred vision, cardiac arrhythmias, sedation, urinary [milwaukeeadvancedpodiatry.com]

 Bladder atony - prolonged intervals between voiding, urinary retention, overflow incontinence. Void every few hours to prevent urinary retention. Impotence is often first [slideshare.net]

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Diabetic Mononeuropathy

Autopsy studies on several patients showed peripheral nerve degeneration ( Leyden 1887 ; Auche 1890 ). [medlink.com]

retention/overflow incontinence Neuropathic oedema Gustatory sweating Anhidrosis (absent sweating) Abnormal pupillary reflexes Treatment Management of autonomic neuropathy [nhshighland.scot.nhs.uk]

Signs and symptoms [ edit ] Illustration depicting areas affected by diabetic neuropathy Diabetic neuropathy affects all peripheral nerves including sensory neurons, motor [en.wikipedia.org]

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Peripheral Motor Neuropathy

peripheral neuropathy primarily affecting motor neurons. [ncbi.nlm.nih.gov]

Retention - often responds to cholinergic agents such as bethanechol Gastroparesis Cisapride (Propulsid ) 10-20mg po tid-qid is best tolerated Also responds to erythromycin [enotes.tripod.com]

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Chronic Pyelonephritis

The restless legs syndrome is a manifestation of sensory peripheral neuropathy. Motor neuropathy is a late phenomenon in uremia. [meddean.luc.edu]

retention 慢性尿閉 chronic non-bacterial prostatitis 慢性非細菌性前立腺炎 chronic cystitis 慢性膀胱炎 mannitol clearance マンニトールクリアランス Cman mannitol diuresis マンニトール利尿 marginal donor マージナル（境界 [glossary.urol.or.jp]

In post-menopausal women, physiological factors (vaginal dryness, urinary incontinence, urinary retention, and prolapse of the pelvic organs) seem to add potential risk to [medicinenet.com]

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Neuromuscular Junction Disorder

Diseases of the peripheral nerves (peripheral neuropathies, or polyneuropathies ) can produce symptoms similar to the motor neuron diseases. [britannica.com]

The characteristic systemic symptoms include hyposalivation and respiratory failure, urinary retention, constipation, and vomiting. [medtextfree.wordpress.com]

retention. [academic.oup.com]

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Paraneoplastic Syndrome

More than half of the patients with the rare osteosclerotic form of myeloma develop a severe predominantly motor paraneoplastic peripheral neuropathy. [theoncologist.onlinelibrary.wiley.com]

retention needing a urethral balloon. [ncbi.nlm.nih.gov]

Autonomic failure results in orthostatic hypotension, abnormal papillary responses, urinary retention, gastrointestinal paresis, hyperhydrosis, impotence, cardiac arrhythmias [healio.com]

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Lumbar Spinal Stenosis

The identification of motor neuron disease and peripheral neuropathies was essential. [ncbi.nlm.nih.gov]

The most commonly observed systemic complications are urinary retention, worsening of heart failure in previously affected patients, delirium, and thoracic pain. [intechopen.com]

retention, fecal incontinence, motor deficit at multiple levels, and saddle anesthesia), or with history of back surgery.11,12,13 Degenerative changes are more common with [appliedradiology.com]

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Meningoencephalitis

Long-term neurologic sequelae of RMSF include cognitive impairment; paraparesis; hearing loss; blindness; peripheral neuropathy; bowel and bladder incontinence; cerebellar [cdc.gov]

Spinal involvement was associated with asymmetric weakness and urinary retention. [ncbi.nlm.nih.gov]

Over 1 week he developed evidence of autonomic instability with urinary retention, fluctuating sinus tachycardia and hypertension, and a paralytic ileus. [mja.com.au]

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CANOMAD Syndrome

Interpretation: Anti-glycolipid antibodies are associated with several distinct peripheral nerve syndromes: Multifocal motor neuropathy is associated with anti-GM1, -GA1 and [southtees.nhs.uk]

Autonomic dysfunction in form of tachycardia, hypertension, and urinary retention are common. NCVs are consistent with axonal neuropathy. [neuroweb.us]

Anti-glycolipid antibodies are associated with several distinct peripheral nerves syndromes: Multifocal motor neuropathy is associated with anti-GM1, -GA1 and -GD1b IgM antibodies [nhsggc.org.uk]

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Brain Stem Disorder

Normal reflexes in a floppy infant almost exclude a severe peripheral neuropathy or motor neuron disorder and make a severe myopathy unlikely. [mrineonatalbrain.com]

Urinary retention, constipation, and weakness of the extremities accompanied by dysesthesias and ataxia soon ensued. [mdedge.com]

Signs of cholinergic autonomic hypofunction such as dilated unreactive pupils, urinary retention, and decreased bowel sounds are important clues (70). [neuroophthalmology.ca]

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Squamous Cell Carcinoma of the Bladder

Immune-Mediated Neuropathies In a separate Phase 3 study of YERVOY 3 mg/kg, 1 case of fatal Guillain-Barré syndrome and 1 case of severe (Grade 3) peripheral motor neuropathy [bms.com]

After the operation he developed recurrent episodes of obstructive LUTS and urinary retention for which he underwent multiple urethral dilations and suprapubic cytostomies [casereports.in]

retention, and indwelling catheters has also been linked to the development of squamous cell carcinoma. [2] Having bladder diverticula may increase the likelihood that an [emedicine.medscape.com]

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