Confused???

[heatie]

Hello. I am concerned about my niece, she is 18 years old and she started with urine retention on March 29, 2008 and to date still has this problem.  She has been on a foley cathetar and now is on it again.  In between, she was self-catheriterizing but had to stop b/c she cannot back up into her kidneys anymore.  She sees a urologist and a neurologist and has had MRI's done but showed no signs of MS.  Her lumbar MRI showed broken bones?? She also has weakness in her right side and had a foot drop.  She has had a scope of her bladder and also had cat scans, blood work and the test where they fill the bladder.  Nobody can come up with a diagnosis for her.  She has no urges and her bladder does not contract whatsoever and she has an abnormal sphincter muscle.  This is something that happened all of a sudden.  She had a spinal tap on June 4, 2008 and is now in the hospital b/c of complications.  They gave her a blood patch and it made it worse.  Can anyone please help me???? She needs answers fast!  Thank you.

[heatie]

Well, my niece came home on June 12th and she is still in a lot of pain.  They have her on 3 different medications.  She cannot walk on her own.  She uses a walker bearing all of her weight and her foot drop became 10x worse.  She has absolutely no feeling in her right leg and foot and her right arm is very weak.  Once in awhile her eyes will get blurry.  She needs help doing everything and she is still on the foley cathetar.  She will be starting rehabilitation at home with nurses.  If she is up too long, she gets dizzy.  Her legs also shake uncontrollably randomly.  We are waiting for her MRI reports to come back and we will be able to figure out where the broken bones are located.  She did fall down the steps shortly before the urine retention started. She had a nerve test done before the spinal tap but they told her it came back fine.  We are so confused at this point. Thanks to your response and I will update you soon.  

[Dr Smitha Mathews]

Hi,

You mentioned that the MRI revealed fractures in the lumbar spines. Could you find out which spines were involved (L1-L5)?

A fracture in those spines can be due to trauma and if there has been trauma there is a good possibility that there has been nerve damage.

Neurogenic bladder (the problem your niece has) could have several reasons. As you mentioned, it is evident that the neurologists are trying to rule out the obvious causes.

The priority should be to get her to recover from the complications of the spinal tap.

Meanwhile, please provide further details regarding how the condition started (any trauma), whether she has any difficulty walking, any vision abnormalities, or any difficulties with maintaining her balance.

Regards