Incontinence in six year old with syringohydromyelia?

Have a child with SM/Chiari? Share issues unique to children and their caregivers.

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Incontinence in six year old with syringohydromyelia?

Postby acupuncturist » Thu Sep 27, 2007 1:59 pm

I have a nearly six year old son who recently developed urinary incontinence. Because he has a dimple at the base of his sacrum, they went ahead and ordered a MRI rather than treating it as a behavioral problem (which I am confident that it is not). The brain and cervical spine were normal, but he has a T6-T12 syrinx, as well as a smaller syrinx around L2 (I have a syrinx T6-T12 as well). I am wondering -- is urinary incontinence a typical symptom associated with this type of problem? If so, can a syrinx cause progressive/irreversible damage to bladder control?

We are working with Dr. Timothy George, a pediatric neurosurgeon in Austin. I am awaiting a phone call from his nurse practitioner today about where we go from here.

Any parents out there who can give me some words of wisdom?

Kristen
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Postby hayla2 » Fri Sep 28, 2007 6:04 am

I just got back from our peds neuro and he said my son has a dimple too. he told me that it was a sign of tethered cord and if it is and he starts having bladder issues that the issues can't be reversed, even after the surgery to fix the cord. did the mri say anything about a tethered cord?
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Postby brianfsmom » Fri Sep 28, 2007 7:13 am

Hi

Skin markers such as dimples and hemangiomas are often indicative of abnormal cord findings. I agree that you should ask about tethered cord. Because of the incontinence and the location of the syrinx, that seems like a likely diagnosis. And yes, a syrinx would also cause the symptoms.

Good luck!

Edit: here is an article that might interest you:

http://www.conquerchiari.org

(can't get the link to work, go to this page, then click on current issue (July 2007) and you will see the article on timing of tethered cord)
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Postby willsmom » Fri Sep 28, 2007 12:45 pm

Please help me understand about the dimple. How big is it? Where is it located?

Thanks.
Yvette
This too shall pass.
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Postby brianfsmom » Fri Sep 28, 2007 12:58 pm

Hi

OK, I am going to try this pasting again:

http://www.mayoclinic.com/health/sacral-dimple/DS00753

Hope it works this time!

Also, willsmom - yes it is certainly possible for patients to lead a "normal" life after decompression surgery. (I saw your post on the other board)

Hope this is helpful.
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Postby willsmom » Fri Sep 28, 2007 3:21 pm

Thanks for the link. Now I know what to look for. But, my question now is wouldn't a dimple like this be diagnosed early in infancy by a pediatrician?
Yvette
This too shall pass.
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Postby brianfsmom » Sat Sep 29, 2007 11:15 am

Willsmom -

yes, a dimple should be noticed right away. In fact, the parents should see them. If you don't see anything on your son's back, he likely doesn't have one.

My son has a small hemangioma on his back. It was dismissed when he was a baby, and it has faded so you can barely see it. I find it very strange that it would be a coincidence that he has this, and then chiari and syrinx. His spinal MRI with contrast was read as no tethered cord, and he hasn't had the symptoms that I read about as those which would lead a surgeon to operate in the absence of obvious TCS on MRI.

I keep an eye on the developments for tethered cord just in case he should have symptoms later on; for now he is doing well after the basic decompression. I hope this is helpful.
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Postby willsmom » Sat Sep 29, 2007 11:38 am

Hi Briansmom,

Your info is very helpful. I guess I am just afraid of what Will may or may not have. Since we haven't had our total brain and spinal MRI I am in the dark somewhat.

Thanks.
Yvette
This too shall pass.
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Postby acupuncturist » Wed Oct 24, 2007 4:52 pm

Luke's dimple was noticed within moments on his birth. Although it is small, it is clearly visible. His is located over the tip of his tailbone. When he was about a week old it was examined via ultrasound (to make sure that it wasn't an opening to his spinal cord). There is no evidence of TCS on his MRI, although our ped neurosurgeon says that his cord is at the low end of normal. Last week we met with the ped urologist, who is the first person willing to consider the syrinx as a potential cause of his incontinence. The initial urological testing indicated that neurogenic bladder is a possibility. I am waiting to hear back from the urologist about what we do next.
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incontinence

Postby Sara » Fri Oct 26, 2007 5:14 pm

my daughter was 4 and a half when she developed incontinence. occult tethered cord a syrinx at the base of her spine were considered the cause. She had her cord untethered at the age of 5. It helped some. She is 13 and still has difficulty, but is dry in the day.
Sara
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