Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Neurofibromatosis and toilet training

Forum: Neurology Forum
Topic: Neurofibromatosis

Re: Neurofibromatosis and toilet training

Re: Neurofibromatosis and toilet training

Posted by ccf neuro M.D. on April 28, 1997 at 23:07:59:

In Reply to: Neurofibromatosis and toilet training posted by Jim Gieszelmann on April 07, 1997 at 22:40:59:

: This may sound like a strange question, but here goes:
My three year old niece has neurofibromatosis. She is currently
undergoing chemotherapy for ocular tumors and has been diagnosed
with a spinal tumor. In the midst of all of this, my sister-in-law
has been attempting to toilet train her. Her daughter seems willing,
but the results have been frustrating. My sister-in-law wonders is
the disease could be having some detrimental effect on the muscle
control needed for satisfactory training. I am inclined to tell her
(as the father of four children) that each child is different, and
that she is probably just not quite ready yet, as could be that case
with ANY child, neurofibromatosis or no. She would like some reassurance on this
question, however.
So, my question is, does the presence of neurofibromatosis inhibit or delay
successful toilet training.
Thanks in advance for your response

=
Jim,
First let me apologize for the long delay in responding to your question. You got "lost" in the middle of other responses and it was not until today that the problem was detected. Toilet training is dependent on the integrity of nerve fibers that go all the way from the brain down to the bottommost levels of the spinal cord. The fibers themselves are there from birth, but it takes your body 2 to 4 years to surround them with an "insulation sheath" known as myelin that allows them to become functional. Until this occurs, no child can be "taught" to go to the potty since up until that time they literally lack any connection or way to send a message from the brain to the bladder or bowel to have any control over. Neurofibromatosis, depending on which type your daughter has, may be associated with tumors in the brain or spinal cord. If such a tumor forms in one of the spinal nerve roots, and then slowly eats its way into the spinal canal via the hole in the vertebra that allows the normal nerve to exit from the spinal cord, the spinal cord can become compressed, and with it perhaps the nerve fibers that control walking, potty training, or even arm movement depending on what level the tumor is at. Thus, if your daughter fails to be toilet trained by age 4, or if there is ANY hint of trouble with her walking, coordination, or sensation, she needs to be seen by her pediatric neurologist right away to rule out the possibility of such a tumor. Otherwise, be patient. Again, let me apologize on behalf of both the institution and Medhelp for the prolonged delay in answering your question.
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