A young man with herpes simplex encephalitis: Andrew and Nathan type urodynamic abnormality

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Fuyuki Tateno
Ryuji Sakakibara
Masashi Yano
Osamu Takahashi
Megumi Sugiyama
Masahiko Kishi
Yohei Tsuyusaki
Akihiko Tateno
Hiroyoshi Suzuki
Yosuke Aiba


brain disease, urodynamics, frontal lobe, micturition reflex, bladder sensation


We described a case of a young man who, after recovery from herpes simplex encephalitis with lesions in the frontal and insular cortices, developed ‘unwitting’ urinary incontinence. A urodynamics revealed 1) markedly-decreased bladder sensation and 2) a biphasic bladder disorder, e.g., before the bladder volume reaches that to provoke detrusor overactivity (DO), without bladder sensation, he is unable to contract his bladder; after provoking DO, he leaks without post-void residual. After starting clean, intermittent self-catheterization, his bladder disorder ameliorated spontaneously. This might be one form of classical ‘Andrew and Nathan type’ frontal urodynamic abnormality. 


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