Meningitis-retention syndrome

Neurological disorder characterized by urinary retention and meningitis

Meningitis-retention syndrome (MRS) is a rare neurological disorder characterized by the combination of aseptic meningitis and acute urinary retention. This syndrome is considered a type of neurogenic bladder dysfunction associated with inflammation of the central nervous system.

Clinical Presentation

Meningitis-retention syndrome typically presents with symptoms of meningitis, such as headache, fever, and neck stiffness, alongside urinary retention. Patients may also experience other neurological symptoms, including photophobia, nausea, and vomiting. The urinary retention is often acute and may require catheterization for management.

Pathophysiology

The exact pathophysiology of meningitis-retention syndrome is not fully understood. It is hypothesized that inflammation of the meninges leads to dysfunction of the autonomic nervous system, particularly affecting the sacral spinal cord segments responsible for bladder control. This results in a failure of the bladder to contract properly, leading to urinary retention.

Diagram of bladder control pathways

Diagnosis

Diagnosis of meningitis-retention syndrome involves a combination of clinical evaluation and diagnostic testing. Lumbar puncture is performed to assess the cerebrospinal fluid (CSF) for signs of aseptic meningitis, such as elevated white blood cell count and protein levels, with normal glucose levels. Imaging studies, such as MRI of the brain and spine, may be conducted to rule out other causes of the symptoms.

Management

Management of meningitis-retention syndrome focuses on symptomatic relief and addressing the underlying inflammation. Treatment may include the use of corticosteroids to reduce inflammation and antiviral or antibiotic therapy if an infectious cause is suspected. Urinary retention is managed with catheterization until normal bladder function is restored.

Prognosis

The prognosis for patients with meningitis-retention syndrome is generally favorable, with most individuals experiencing complete recovery of bladder function and resolution of meningitis symptoms. However, the duration of symptoms can vary, and some patients may experience recurrent episodes.

Related Pages

• Meningitis
• Neurogenic bladder
• Aseptic meningitis
• Autonomic nervous system