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Children with enuresis can be classified into those who wet their beds only at night (monosymptomatic enuresis, mE), and those who additionally suffer from daytime symptoms, such as urgency or incontinence (non-monosymptomatic enuresis, nmE). Evidence is growing that enuresis may have a central origin: bedwetting children have lower brainstem reflex control (impaired prepulse inhibition) than normal controls. However, findings on this subject are inconsistent. To date, there has been no study in pediatric patients according to the type of enuresis. With the aim of determining whether mE and nmE children differ in terms of central reflex control, we divided 30 enuretic children into two groups (mE and nmE) based on data recorded in a bladder diary and clinical history (19 with history of diurnal urge, 11 without; age 5-14 years). Prepulse inhibition (PPI) of the startle reflex of the children was measured and compared between groups. A significant difference in PPI was observed between the groups, with the nmE group having a lower median PPI level than the mE group (10 vs. 73%, respectively; p = 0.0002). These findings lead to the assumption that a loss of central control plays a role only in the etiology of nmE. Moreover, they may throw a new light on the classification of enuresis.
Hospital for Children and Adolescents, University Leipzig, Leipzig, Germany.
This article was published in the following journal.
Name: Pediatric nephrology (Berlin, Germany)
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Monosymptomatic nocturnal enuresis, defined as the involuntary loss of urine during the night at an age where voluntary bladder control should have been attained and on the background of n...
Involuntary discharge of URINE after expected age of completed development of urinary control. This can happen during the daytime (DIURNAL ENURESIS) while one is awake or during sleep (NOCTURNAL ENURESIS). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis).
Contractions of the abdominal muscles upon stimulation of the skin (superficial abdominal reflex) or tapping neighboring bony structures (deep abdominal reflex). The superficial reflex may be weak or absent, for example, after a stroke, a sign of upper (suprasegmental) motor neuron lesions. (Stedman, 25th ed & Best & Taylor's Physiological Basis of Medical Practice, 12th ed, p1073)
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An abnormal reflex consisting of dorsiflexion of the great toe and abduction of the other toes in response to cutaneous stimulation of the plantar surface of the foot.
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