Re: nocturnal myoclonus & MG

Posted By CCf neuro Md *!* on December 31, 1997 at 16:09:28:

In Reply to: nocturnal myoclonus & MG posted by Karen on November 11, 1997 at 08:03:19:







: I have had nocturnal myoclonus for about 2/92. I am currently on Klonipin (klonopin) and Baclofen with good control.  I also have MG (diagnoised in 95, but probably there in 2/92) which is also in good control.  
My main concern is bladder urgency and incontinence since 1993.  Testing
has shown that I have abd unstable bladder - no other problems assoc with the bladder.  I have been on Levbid at night with good control until the past year.  Every day the urgency and incontinence gets worse. I have tried many different anticholinergics during the day, but my eye droop becomes severe.  Kegals are not working either.I have also been told that the incontence may be a side effect of the Bacolfen and/or Klonipin (klonopin) - and that alternative drugs for the myoclonus woud not be any better.
Is the bladder problem related to the MG?  Any other suggestions to control the incontinence? (I am a 45 year old professional and find incontnence unacceptable at this point in my life.)  Any assistance would be greatly appreciated




Urinary incontinence is  infrequently reported in myasthenia gravis, I have however performed a 20 year literature search on the Medline data base and retrieved four case reports of incontinence, both urinary and fecal in patients with myasthenia.
In one case these were the presenting symptoms and in another case the symptoms responded to steroid therapy and removal of the thymus gland.
There is one case report in the journal Lancet from August 1, 1987 which reports the use of an artificial anal sphincter in a man with myasthenia gravis. The prosthesis used was in fact a urinary sphincter prosthesis AMS 800, and it is reported as giving the patient complete control.
This mode of therapy is obviously not widely used however if you require more information you might wish to obtain a referral to a specialized urology center for review  of this option if available. This information is provided for
general medical education purposes only.
Please consult your physician for diagnostic and treatment options of your specific medical condition.