A case of urination apraxia: phenomenology of the syndrome and differential diagnosis with other forms of post-stroke cortical dysuria

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We described the clinical features of urination apraxia as one of post-stroke cortical neurogenic disturbances of bladder function. Neurological and urological symptoms and the data of urodynamic and neurophysiological studies in a patient with urination apraxia resulting from the right-hemispheric lesion in the projection of cingulate gyrus are demonstrated. The differential diagnosis was carried out with the case of motor detrusor atony after stroke in the right temporal lobe and the insula, and with the case of imperative urination after stroke in the left frontal lobe in the projection of cingulate gyrus.

About the authors

M. A. Domashenko

Research Center of Neurology

Email: ncnmaximova@mail.ru
Russian Federation, Moscow

P. G. Shvarts

Research Center of Neurology

Email: ncnmaximova@mail.ru
Russian Federation, Moscow

S. V. Popov

Research Center of Neurology

Email: ncnmaximova@mail.ru
Russian Federation, Moscow

I. V. Borodulina

Research Center of Neurology

Email: ncnmaximova@mail.ru
Russian Federation, Moscow

V. V. Shvedkov

Research Center of Neurology

Email: ncnmaximova@mail.ru
Russian Federation, Moscow

Marina Yu. Maksimova

Research Center of Neurology

Author for correspondence.
Email: ncnmaximova@mail.ru
Russian Federation, Moscow

Albert S. Kadykov

Research Center of Neurology

Email: ncnmaximova@mail.ru
ORCID iD: 0000-0001-7491-7215

D. Sci. (Med.), Professor, senior researcher, 3rd Neurological department

Russian Federation, Moscow


  1. Бехтерев В.М., Миславский Н.А. Центры движения мочевого пузыря в головном мозгу. Арх. Психиатр. 1888; XII: 12–16.
  2. Меер Х.Х., Готлиб Р. Эксперим. Фармакол. 1925; 2: 34–56.
  3. Мулач А.Н. Нейрогенные нарушения мочеиспускания в восстановительном и резидуальном периодах ишемического инсульта. Автореф. дис. канд. мед. наук. М., 2012.
  4. Шварц П.Г. Нейрогенные нарушения мочеиспускания у больных с острыми и хроническими сосудистыми заболеваниями головного мозга (клиника, диагностика и лечение) Автореф. дис. докт. мед. наук. М., 2013.
  5. Andersen J.T., Bradley W.E. Abnormalities of bladder innervation in diabetes mellitus. Urology 1976; 7: 442–448.
  6. Barrington F.J.F. The relation of the hind-brain to micturition. Brain 1921; 44: 23–53.
  7. Barrington F.J.F. The effect of lesions of the hind- and mid-brain on micturition in the cat. Q. J. Exp. Physiol. 1925; 15: 81–102.
  8. Blok B.F., Holstege G. Direct projections from the periaqueductal gray to the pontine micturition center M-region. Neurosci. Lett. 1994; 166: 93–96.
  9. Blok B.F., Willemsen A.T., Holstege G. A PET study on the brain control of micturition in humans. Brain 1997; 20: 111–121.
  10. Blok B.F., Holstege G. Ultrastructural evidence for a direct pathway from the pontine micturition center to the parasympathetic preganglionic motoneurons of the bladder of the cat. Neurosci. Lett. 1997; 222: 195–198.
  11. De Groat W.C. Integrative control of the lower urinary tract: preclinical perspective. Br. J. Pharmacol. 2006; 147 (Suppl. 2): 25–40.
  12. De Groat W.C. Nervous control of the urinary bladder of the cat. Brain Res, 1975; 87: 201–211.
  13. Griffiths D.J. The pontine micturition centres. Scand. J. Urol. Nephrol. 2002; 210: 21–26.
  14. Holstege G., Griffiths D., deWall H., Dalm E. Anatomical and physiological observations on supraspinal control of bladder and urethral sphincter muscles in cats. J. Comp. Neurol. 1986; 250: 449–461.
  15. Holstege G., Kuypers H.G., Boer R.C. Anatomical evidence for direct brain stem projections to the somatic motoneuronal cell groups and autonomic preganglionic cell groups in cat spinal cord. Brain Res. 1979; 171: 329–333.
  16. Liu R.P.C. Laminar origins of spinal projection neurons to the periaqueductal gray of the rat. Brain Res. 1983; 264: 118–122.
  17. Loewy A.D., Saper C.B., Baker R.P. Descending projections from the pontine micturition center. Brain Res. 1979; 172: 533–538.
  18. Mahony D., Laferte R.O., Blais D.J. Integral storage and voiding reflexes. Neurophysiologic concept of continence and micturition. Urology 1977; 9: 95–106.
  19. Morrison J., Fowler C., Birder L. et al. Neural control of the bladder. In: Incontinence (ed. P.Abrams, L.Cardozo, S.Khoury, A.Wein). Paris: Health Publications Ltd, 2005: 363–422.
  20. Roppolo J.R., Nadelhaft I., de Groat W.C. The organization of pudendal motoneurons and primary afferent projections in the spinal cord of the rhesus monkey revealed by horseradish peroxidase. J. Comp.Neurol. 1985; 234: 475–488.
  21. Shefchyk S.J. Sacral spinal interneurones and the control of urinary bladder and urethral striated sphincter muscle function. J. Physiol. 2001; 533: 57–63.

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Copyright (c) 2014 Domashenko, M.A., Shvarts P.G., Popov S.V., Borodulina I.V., Shvedkov V.V., Maximova M.Y., Kadykov A.S.

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