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Thread: LMN bladder in T8 injury

  1. #1

    LMN bladder in T8 injury

    I recently had a urodynamic study completed which perplexed but did not concern my urologist. However, it has left me with a lot of concerns. My urodynamic a showed LMN flaccid bladder with zero contractions. I was diagnosed with T8 Asia A flaccid paralysis 3-17-2011 after a crush injury. My first urodynamic a showed UMN bladder. I had stopped baclofen three days before urodynamics and I am not on any other medications. The reason for taking baclofen relates to part of why my concern is increasing over my changing symptoms in the last year. In November I started baclofen due to spasms in my arms. These spasms are accompanied by weakness and numbness that started about one year ago and then in October the spasms began when doing things like opening a door and grabbing a glass. I have had some other various symptoms but the previous ones are the most bothersome. Then in the last 6 months I have been struggling with fatigue and recall of basic words. My cervical spine MRI was unremarkable which led to a brain MRI to confirm that I did not have a pituitary tumor, at this time all I know is it is not a pituitary tumor but I have no other information on the results until July as my follow up was rescheduled due to my physiatrist being out.

    My my doctors seem to lack concern on the decline that I have experienced over the past year. Is this something to be concerned about? Should I be pushing the issue more with them to find out what is going on rather than simply taking medicine to cover up symptoms. I work full time and it is impacting my job. I am going to school for my Masters but I just had to request a break. I am having to transition to a power chair as I am very limited in my manual chair with the numbness and weakness I now have. At this time all I have gotten from my physiatrist of maybe forty hours a week or doing school is too much. I am twenty seven years old. I enjoy having an active life and despite my injury I was able to keep active and do as much as I wanted until a year ago and particularly in the past six months. The only other suggestion was to start physical therapy to aid in regaining muscle due to my muscles atrophying in my arms. I am not against taking necessary steps to stay healthy and improve my life but I feel like I need to know what is happening so I can have an appropriate plan.

    SCI nurses, please provide any insight and recommendations you can as I feel like I am the only one fighting for answers.

  2. #2
    It is unusual to change from an overactive bladder to an undersctive bladder as those are the correct terms used in a uro dynamics study. The other issues mentioned such as Spasms etc.. in your arms are not consistent with a thoracic injury and not sure about the pituitary issue which has nothing to do with spasms or atrophy. My suggestion is see a good neurologist. CWO

  3. #3
    Thank you for your reply. I will request to see a neurologist at my next appointment. I did not have the above problems initially after my injury and I agree that it is not consistent with my injury. I was just unsure if I should keep pushing for answers. Your reply confirmed for me that I need to find the right doctor to evaluate my situation.

  4. #4
    Have you been assessed for a syrinx? I have seen a descending syrinx (one moving down the cord instead of to higher levels in the cord) cause loss of reflex activity in those with SCI. It has caused several of my patients to change from a UMN to a LMN bladder, and also to loose reflex erections.

    (KLD)

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