Micturitional disturbance due to bilateral medial frontal lobe lesions in a patient with multiple sclerosis.

ABSTRACT

A 41-year-old man with multiple sclerosis (MS) complained of nocturnal enuresis at the third exacerbation. Neurological examination revealed echopraxia, forced grasp reflexes and palmo-mental reflexes. The urodynamic studies showed neither spinal cord nor peripheral nerve involvements. His brain magnetic resonance images (MRIs) revealed new lesions at the bilateral medial frontal lobes. The intravenous methylprednisolone therapy improved nocturnal enuresis and made brain MRI lesions smaller and gone. In addition to frequently observed spinal cord lesions, we should consider some medial frontal lesions to be responsible for micturitional disturbance in patients with MS.