Incontinence in Intellectual Disability: An Under Recognized Cause
Many children with Down syndrome may develop urinary incontinence during adolescence or nearing adulthood. Most often low mental ability, behavioural issues, urinary tract infection, hypothyroidism, atlanto-axial subluxation or sexual abuse may be suspected to be the reason. We report a case of Do...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2015-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/6448/14019_CE(RA1)_F(T)_PF1(AGAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Many children with Down syndrome may develop urinary incontinence during adolescence or nearing adulthood. Most often low mental
ability, behavioural issues, urinary tract infection, hypothyroidism, atlanto-axial subluxation or sexual abuse may be suspected to be the
reason. We report a case of Down syndrome with tethered cord syndrome (TCS) and Lipoma of Filum terminale with Cauda equina
in normal position, as a cause of bowel and bladder incontinence. The need for operating with Cauda Equina in normal position is
debated. But a conscious decision was taken to operate and the incontinence improved markedly which was documented by using a
standardized questionnaire (King’s questionnaire) and thereby making a difference in the child’s life. A literature search did not result in
any case of Down syndrome with tethered cord syndrome and secondary incontinence as presentation. Considering the possibility of
TCS as a cause of incontinence, often neglected even in normal children, careful evaluation and correction of such problems will make a
difference in the life of many intellectually disabled children. Incontinence should not be casually attributed to intellectual disability without
ruling out other causes. |
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| ISSN: | 2249-782X 0973-709X |