The phenomenon of detrusor hyperactivity as a manifestation of a pathological autonomic reflex

Pharmateca ◽  
2021 ◽  
Vol 3_2021 ◽  
pp. 113-119
Author(s):  
V.V. Danilov Danilov ◽  
◽  
Keyword(s):  
Autonomic Reflex ◽  
Detrusor Hyperactivity

1132: Creation of a Somatic-Autonomic Reflex Pathway for Treatment of Neurogenic Bladder in Patients with Spinal Cord Injury: Preliminary Results of First 2 USA Patients

2005 ◽  
Vol 173 (4S) ◽  
pp. 307-308 ◽  
Author(s):  
Christopher E. Kelly ◽  
Chuan-Guo Xiao ◽  
Howard Weiner ◽  
Aleksandar Beric ◽  
Victor W. Nitti ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neurogenic Bladder ◽  
Reflex Pathway ◽  
Preliminary Results ◽  
Cord Injury ◽  
Autonomic Reflex

scholarly journals Use of Botulinum Neurotoxin in Parkinson’s Disease: A Critical Appraisal

Toxins ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 87
Author(s):  
Wolfgang H. Jost
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Botulinum Neurotoxin ◽  
Critical Appraisal ◽  
Freezing Of Gait ◽  
Sufficient Data ◽  
Pisa Syndrome ◽  
Focal Hyperhidrosis ◽  
Detrusor Hyperactivity ◽  
Important Indication

For well over 30 years, the botulinum neurotoxin (BoNT) has been used for a large number of indications, some of which however have not been licensed. Admittedly, approval varies in many countries and this permits a large spectrum for evaluation. Thus, BoNT is used for patients with Parkinson’s disease (PD) and other Parkinson’s syndromes (PS) in varying degrees of frequency. We have to distinguish between (1) indications that are either approved or (2) those not approved, (3) indications that might be a result of PS and (4) finally those which appear independent of PS. The most important indication for BoNT in PS patients is probably sialorrhea, for which approval has been granted in the majority of countries. Cervical dystonia is a frequent symptom in PS, with anterocollis as a specific entity. A further indication is blepharospasm in the different forms, especially the inhibition of eyelid opening in atypical PS. The use of BoNT in cases of camptocormia, the Pisa syndrome and neck rigidity is still a matter of debate. In dystonia of the extremities BoNT can be recommended, especially in dystonia of the feet. One well-known indication, for which however sufficient data are still lacking, involves treating tremor with BoNT. As to autonomic symptoms: Focal hyperhidrosis and detrusor hyperactivity can be mentioned, in this last case BoNT has already been approved. A number of further but rare indications such as freezing-of-gait, dyskinesia, and dysphagia will be discussed and evaluated.

Detrusor Underactivity and Detrusor Hyperactivity with Impaired Contractility

2014 ◽  
Vol 9 (4) ◽  
pp. 341-349 ◽  
Author(s):  
Christopher T. Brown ◽  
Sylvester Onyishi ◽  
Christian O. Twiss
Keyword(s):  
Detrusor Underactivity ◽  
Detrusor Hyperactivity

scholarly journals The Autonomic Reflex Screen in Healthy Participants from Southwestern Ontario

2013 ◽  
Vol 40 (6) ◽  
pp. 848-853 ◽  
Author(s):  
Colleen T. Ives ◽  
Michael J. Berger ◽  
Kurt Kimpinski
Keyword(s):  
Valsalva Maneuver ◽  
Age Group ◽  
Group 14 ◽  
Axon Reflex ◽  
Autonomic Disorders ◽  
Reflex Testing ◽  
The Mean ◽  
Autonomic Reflex ◽  
Parasympathetic Function ◽  
Healthy Participants

Background:The autonomic reflex screen (ARS) is a composite of well-defined tests of various autonomic domains and is an essential part of the diagnosis of autonomic disorders. Institutional and regional differences exist and necessitate the ongoing development of control values for the ARS. Here we present data obtained from healthy participants from Southwestern Ontario.Methods:A total of 121 healthy individuals underwent quantitative sudomotor axon reflex testing (QSART), heart rate response to deep breathing (HRDB), and Valsalva maneuver using standard protocols as part of the ARS.Results:Sweat volumes obtained during QSART are presented by site (forearm, proximal leg, distal leg and foot) and by gender. Data is expressed as the mean sweat volume per site with the associated 2.5th, 5th and 95th percentiles. Data for males and females is also stratified by age group (14-25, 26-40 and 41-76 years). Measurements of cardiovagal parasympathetic function including HRDB and Valsalva ratio are stratified by age group (14-25, 26- 40 and 41-76 years). Data is expressed as the mean with associated percentiles (2.5, 5, 95 and 97.5 percentiles).Conclusions:The current manuscript provides control data for the various components of the ARS to aid in the diagnosis of autonomic disorders.

Hypothalamic Activation in Trigeminal Autonomic Cephalgia: Functional Imaging of an Atypical Case

Cephalalgia ◽  
2004 ◽  
Vol 24 (9) ◽  
pp. 753-757 ◽  
Author(s):  
T Sprenger ◽  
M Valet ◽  
M Hammes ◽  
P Erhard ◽  
A Berthele ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Paroxysmal Hemicrania ◽  
Cerebral Activation ◽  
Atypical Case ◽  
Clear Cut ◽  
Oxygen Administration ◽  
Autonomic Reflex ◽  
Trigeminal Autonomic Cephalgia ◽  
Hypothalamic Activation

We report headache induced BOLD changes in an atypical case of trigeminal autonomic cephalgia (TAC). A 68-year-old patient was imaged using fMRi during three attacks of a periorbital head-pain with a average duration of 3 min. During the attacks, left sided conjunctival injection, rhinorrhea, lacrimation, facial sweating and hypersalivation were apparent. These attacks were usually partly responsive to oxygen administration but otherwise refractory to any drug. The patient described either attacks with a duration of one minute or less or longer attacks persisting for maximum of 20 min with headaches occurring up to 100 times a day. When considering the symptoms, frequency, duration and therapeutic response of the patient's headache, no clear-cut classification to one of the subtypes of trigeminal autonomic cephalgias (cluster headache, paroxysmal hemicrania, SUNCT) or trigeminal neuralgia was possible. The cerebral activation pattern was similar but not identical to those previously observed in cluster headache and SUNCT with a prominent activation in the hypothalamic grey matter. This case study underlines the conceptual value of the term TAC for the group of headaches focusing around the trigeminal-autonomic reflex. Our results emphasize the importance of the hypothalamus as key region in the pathophysiology of this entity.

Abstract 12919: Quantitative Assessment of Cardiovascular Autonomic Impairment in Cancer Survivors: A Single Center Experience

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Benjamin Noor ◽  
Shannel Akhavan ◽  
Michael Leuchter ◽  
Eric H Yang ◽  
Olujimi A Ajijola
Keyword(s):  
Cancer Survivors ◽  
Autonomic Dysfunction ◽  
Cancer Diagnosis ◽  
Alkylating Agents ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Inappropriate Sinus Tachycardia ◽  
Cardiovascular Autonomic Dysfunction ◽  
Autonomic Testing ◽  
Reflex Testing ◽  
Autonomic Reflex

Background: Cardiovascular autonomic dysfunction in cancer survivors is poorly understood. Objectives: To better characterize the clinical characteristics and types of autonomic dysfunction in this population. Methods: A retrospective analysis of cancer survivors within an academic cardio-oncology program referred for suspected autonomic dysfunction was performed. Autonomic reflex testing of adrenergic, cardiovagal, and sudomotor function was done. Patients with pre-existing autonomic dysfunction prior to their cancer diagnosis were excluded. Results: Of approximately 282 patients in the UCLA Cardio-Oncology program, twenty-four patients met the inclusion criteria. Twenty-two had autonomic impairment on autonomic reflex testing. Eight patients were female, and the mean age at time of autonomic testing was 51.3 years. The average duration from cancer diagnosis to autonomic testing was 10.3 years. The reasons for referral included dizziness, tachycardia, palpitations, and syncope. The majority of patients (75%) had hematologic disorders. The most common chemotherapies administered were vinca alkaloids (54.2%), alkylating agents (66.7%), and anthracyclines (54.2%). Most patients received radiation to the thorax (66.7%) and neck (53.3%). Eleven patients had mild autonomic impairment, seven had moderate, and four had severe autonomic impairment. Dysfunction was commonly present in the sympathetic and parasympathetic branches, but most pronounced in the sympathetic system. The majority of patients were diagnosed with orthostatic hypotension (50%), inappropriate sinus tachycardia (20.8%), and postural orthostatic tachycardia syndrome (12.5%) and had subjective improvement with treatment. Conclusion: Cardiovascular autonomic dysfunction occurs in cancer survivors, and commonly affects both the sympathetic and parasympathetic systems. Symptom recognition in patients should prompt autonomic testing and treatment where appropriate.

scholarly journals Urinary dysfunction with detrusor hyperactivity in women with Parkinson's disease cannot be blamed as a factor of worsening motor performance

2013 ◽  
Vol 71 (9A) ◽  
pp. 591-595 ◽  
Author(s):  
Raimundo Nonato Campos-Sousa ◽  
Elizabeth Maria Aparecida Barasnevicius Quagliato ◽  
Kelson James Almeida ◽  
Inacio Augusto Dias de Castro ◽  
Viriato Campelo
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Performance ◽  
Rating Scale ◽  
Clinical Symptoms ◽  
Urinary Dysfunction ◽  
Clinical Aspects ◽  
Yahr Scale ◽  
Disease Rating ◽  
Detrusor Hyperactivity

Introduction Detrusor hyperactivity is the leading cause of urinary dysfunction in Parkinson's disease (PD). There are few studies correlating PD clinical aspects with this autonomic feature. Methods A cohort of 63 women with PD were prospectively examined for assessment of clinical aspects and disease severity using unified Parkinson's disease rating scale and Hoehn-Yahr scale, respectively. The urologic function was evaluated by the urodynamic study. Two groups were categorized at this time - groups with and without detrusor hyperactivity. After seven years, the same parameters were re-evaluated. Results Progression of the disease on mental scores was found in the group with detrusor hyperactivity. On follow-up, clinical symptoms and severity did not show significant worsening between the groups. Conclusion Detrusor hyperactivity is a frequent urodynamic finding in PD, and even though it is associated with dopaminergic dysfunction, it cannot be blamed as a factor of worsening motor performance, but is probably associated with poor cognitive and mental prognosis.

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