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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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