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Neurology  (Expert Forum)
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MRI and pacemaker
Answered by
Lama Chahine, MD - Neurology
Cleveland Clinic Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.

MRI and pacemaker

by vanvechten, Nov 06, 2009 09:36AM
Can an MRI be done of the spinal area alone?  I've had 2 spinal taps, but no MRI due to pacemaker.  I now have a new neurological problem that I did not expect---severe bladder retention.  I must use the catheter 3/4 times per day.  I'm skimming patients' responses and noticing that the spinal area could be the culprit, hence my question. Thanks!

by Lama Chahine, MD, Nov 07, 2009 10:19AM
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

In general, an MRI of the brain or any part of the spine can not be done when there is an implanted pacemaker. This is because the pacemaker is made of specific metals, and the magnet from the MRI can heat up the metal, leading to burning. in addition, the signal from the pacemaker can be "scrambled" from the force exerted by the magnet.

You are correct in stating that urinary retention can be the result of neurologic problems. The problem could be in 3 parts of the nervous system: the lower spinal cord (what is termed the conus area), the nerves after they come out of the spinal cord (what is termed the cauda equina), or the autonomic nervous system, the part of the nervous system located in various parts throughout the body that controls functions such as urination, blood pressure, and heart rate. Each one of these areas can cause urinary retention, and identifying which one is based in part on what other symptoms or signs are occuring, such as weakness or sensory loss. Other potential tests depend on where the problem is thought to be: an MRI is usually done to examine the spinal cord and cauda equina, but when this is not possible, a CT scan with contrast, or a myelogram can be done, when there is a high suspicion that the cause of the urinary symptoms is related to the spinal cord or nerves. A test called EMG/NCS can test how nerves are conducting electricity and how muscles respond. In some causes, the dysfunction is restricted strictly to the bladder, such as when the bladder does not contract properly, and other parts of the nervous system may not be affected.

Continued evaluation by your urologist and neurologist is recommended.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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