Portal de Periódicos da CAPES

CENTRAL NERVOUS SYSTEM INVOLVEMENT IN NOCTURNAL ENURESIS: EVIDENCE OF GENERAL NEUROMOTOR DELAY AND SPECIFIC BRAINSTEM DYSFUNCTION

2001; Lippincott Williams & Wilkins; Volume: 166; Issue: 6 Linguagem: Inglês

10.1016/s0022-5347(05)65613-3

1527-3792

Alexander von Gontard, DAGMAR SCHMELZER, Stephanie Seifen, Ralf Pukrop,

Sexual Differentiation and Disorders

No AccessJournal of UrologyPEDIATRIC UROLOGY: International Enuresis Research Center Workshop1 Dec 2001CENTRAL NERVOUS SYSTEM INVOLVEMENT IN NOCTURNAL ENURESIS: EVIDENCE OF GENERAL NEUROMOTOR DELAY AND SPECIFIC BRAINSTEM DYSFUNCTION ALEXANDER VON GONTARD, DAGMAR SCHMELZER, STEPHANIE SEIFEN, and RALF PUKROP ALEXANDER VON GONTARDALEXANDER VON GONTARD , DAGMAR SCHMELZERDAGMAR SCHMELZER , STEPHANIE SEIFENSTEPHANIE SEIFEN , and RALF PUKROPRALF PUKROP View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65613-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: To assess the involvement of central nervous system factors in the etiology of childhood nocturnal enuresis, an ongoing study of the fine neurology and neurophysiology has been instituted. Materials and Methods: A total of 22 patients 8 to 14 years old were subcategorized sporadic and familial groups. Patients underwent a number of examinations, including a complete family pedigree; blood samples for linkage analyses; pediatric examination; urinalysis; uroflowmetry with pelvic floor electromyography; 24-hour flow charts; parental micturition questionnaire; child behavior checklist; intelligence test; standardized child psychiatric interview; acoustic, visual and event related late evoked potentials; Zurich Neuromotor Test Battery and the startle-blink paradigm. In this preliminary report only the results of the Zurich Neuromotor Test Battery and startle-blink paradigm are reported. Results: In the Zurich Neuromotor Test Battery patients with enuresis had a longer timed performance but did not have more associated movements than the controls. In the startle-blink modulation paradigm inhibition of the electromyograph amplitudes was greatest following prestimulation with an interval of 120 milliseconds. This inhibition is known to be reduced among patients with enuresis compared to nonwetting children. The results indicated a general developmental (neuromotor) delay, in addition to specific dysfunction of the brain stem in patients with enuresis. The pre-pulse inhibition, as well as inhibition of bladder emptying at sleep, are regulated by brainstem centers in close anatomical proximity to the pontine micturition center and by analogous mechanisms. Conclusions: Reduced pre-pulse inhibition may represent a genetically transmitted trait indicative of nocturnal enuresis. References 1 : Cure of nocturnal enuresis: why isn't desmopressin very effective?. Ped Nephrol1996; 10: 667. Google Scholar 2 : Nocturnal enuresis in childhood. Dev Med Child Neurol1976; 18: 577. Google Scholar 3 : Developmental history and neurological findings in enuretic children. Dev Med Child Neurol1989; 31: 728. Google Scholar 4 : Asthma, enuresis, and chronic illness: longterm impact on height. Arch Dis Child1995; 73: 298. Google Scholar 5 : Enuresis in seven-year-old children. Acta Paediatr Scand1988; 77: 148. Google Scholar 6 : Nocturnal enuresis and minor neurological dysfunction at 12 years: a follow-up study. Dev Med Child Neurol1991; 33: 439. Google Scholar 7 : Behavior and bladder disturbance of enuretic children. Dev Med Child Neurol1984; 26: 781. Google Scholar 8 : Enuresis in children. J Pediatr1961; 58: 806. Google Scholar 9 : Somatic correlates of functional enuresis. Eur Child Adolesc Psychiatr1999; 8: 117. Google Scholar 10 : Sleep cystometries in children with nocturnal enuresis. J Urol1989; 141: 1156. Link, Google Scholar 11 : Childhood enuresis: I sleep patterns and psychopathology. Arch Gen Psychiatr1980; 37: 1139. Google Scholar 12 : Sleep of children with enuresis: a polysomnographic study. Pediatrics1999; 103: 1193. Crossref, Medline, Google Scholar 13 : Sleep patterns in children with nocturnal enuresis. Scand J Urol Nephrol, suppl.1995; 173: 55. Google Scholar 14 : Nocturnal enuresis: sleep disturbance and behavioral patterns. Acta Paediatr1994; 83: 772. Google Scholar 15 : Elevated sleep arousal thresholds in enuretic boys: clinical implications. Acta Paediatr1997; 86: 381. Google Scholar 16 : Maturation of startle modulation. Psychophysiology1986; 23: 624. Google Scholar 17 : Presimulation-induced startle modulation in attention-deficit disorder and nocturnal enuresis. Psychophysiology1992; 29: 437. Google Scholar 18 : Prepulse inhibition of startle and the neurobiology of primary nocturnal enuresis. Biol Psychiat1999; 45: 1455. Google Scholar 19 Largo R.H. Caflisch J.A. and von Siebenthal K. Neuromotor development from kindergarten age to adolescence. Unpublished data Google Scholar 20 : Molecular genetics of nocturnal enuresis: clinical and genetic heterogeneity. Acta Paediatr1998; 87: 571. Google Scholar From the Departments of Child and Adolescent Psychiatry, and Psychiatry, University of Cologne, Cologne, Germany© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byLabrie J, de Jong T, Nieuwhof-Leppink A, van der Deure J, Vijverberg M and van der Vaart C (2010) The Relationship Between Children With Voiding Problems and Their ParentsJournal of Urology, VOL. 183, NO. 5, (1887-1891), Online publication date: 1-May-2010.Baeyens D, Roeyers H, Naert S, Hoebeke P and Vande Walle J (2007) The Impact of Maturation of Brainstem Inhibition on Enuresis: A Startle Eye Blink Modification Study With 2-Year FollowupJournal of Urology, VOL. 178, NO. 6, (2621-2625), Online publication date: 1-Dec-2007.Baeyens D, Roeyers H, Hoebeke P, Antrop I, Mauel R and Walle J (2018) The Impact of Attention Deficit Hyperactivity Disorders on Brainstem Dysfunction in Nocturnal EnuresisJournal of Urology, VOL. 176, NO. 2, (744-748), Online publication date: 1-Aug-2006.HJALMAS K, ARNOLD T, BOWER W, CAIONE P, CHIOZZA L, von GONTARD A, HAN S, HUSMAN D, KAWAUCHI A, LÄCKGREN G, LOTTMANN H, MARK S, RITTIG S, ROBSON L, WALLE J and YEUNG C (2018) NOCTURNAL ENURESIS: AN INTERNATIONAL EVIDENCE BASED MANAGEMENT STRATEGYJournal of Urology, VOL. 171, NO. 6 Part 2, (2545-2561), Online publication date: 1-Jun-2004.HAGSTROEM S, KAMPERIS K, RITTIG S, RIJKHOFF N and DJURHUUS J (2018) MONOSYMPTOMATIC NOCTURNAL ENURESIS IS ASSOCIATED WITH ABNORMAL NOCTURNAL BLADDER EMPTYINGJournal of Urology, VOL. 171, NO. 6 Part 2, (2562-2566), Online publication date: 1-Jun-2004. Volume 166Issue 6December 2001Page: 2448-2451 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordsneurophysiologyenuresisreaction startleblinkingMetricsAuthor Information ALEXANDER VON GONTARD More articles by this author DAGMAR SCHMELZER More articles by this author STEPHANIE SEIFEN More articles by this author RALF PUKROP More articles by this author Expand All Advertisement PDF downloadLoading ...