Highlights
- •We evaluate urinary lower urinary tract symptoms in patients with functional movement disorders.
- •Lower urinary tract symptoms were seen in 20% patients of the 150 studied patients.
- •Patients with fixed dystonia are more likely to report lower urinary tract symptoms.
- •Specialist investigation and treatment can lead to improvement in these patients.
Abstract
Introduction
Functional movement disorders (FMD) are not associated with the kind of structural
or biochemical alterations seen in other movement disorders and therefore would be
unlikely to be associated with lower urinary tract (LUT) dysfunction. However, LUT
symptoms have been observed in patients with FMD.
Objective
To evaluate the frequency and pattern of LUT symptoms, their possible nature and the
impact they have on the quality of life of patients with FMD.
Methods
The clinical records of patients with FMD were reviewed retrospectively and patients
reporting LUT symptoms were invited to complete standardised validated questionnaires—Urinary
Symptom Profile (USP) and Short Form—Qualiveen (SFQ). Management of LUT dysfunction
was also reviewed.
Results
Out of the 150 patients with clinically established (n = 97) or probable (n = 53) FMDs, thirty (20%) self-reported LUT symptoms. Twenty two of these completed the
USP and SFQ questionnaires. Overactive bladder symptoms were most commonly reported
(n = 14; 63.6%). Patients with fixed dystonia reported more severe LUT symptoms and had
higher SFQ scores as compared to patients with other FMDs (p = 0.01). Five patients with significant LUT symptoms had been referred to uroneurology.
Of them, three had urinary retention managed with sacral neuromodulation, two had
overactive bladder and were managed conservatively.
Conclusion
LUT dysfunction can be seen in 20% patients with FMD. Patients with fixed dystonia
are more likely to report LUT dysfunction which can be severe. It may be advisable
to ask for LUT symptoms in all patients with FMD and be more proactive in referring
them for specialist investigation and treatment.
Keywords
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Article info
Publication history
Published online: December 29, 2015
Accepted:
December 28,
2015
Received in revised form:
December 10,
2015
Received:
October 2,
2015
Identification
Copyright
© 2016 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
