Neurophysiological aspects of enuresis.

Abstract

The effects on the bladder motility of ablation and stimulation of certain peripheral and central nervous structures in the cat are summarized. It appears that the bladder emptying is controlled by two reflex mechanisms, viz., a spinal adaptation reflex with the effect of counteracting the rise in bladder pressure on filling, and the pontine micturition reflex. The excitability of the latter is influenced by more rostrally situated areas. By lesioning the medial and lateral parts of the amygdala nuclei complex it was found that the medial part inhibits and the lateral part facilitates micturition. From previous works it is known that the same parts of the complex respectively increase and decrease the reflex threshold of striated muscles, and that the medial part is necessary for defence and passive avoidance behaviour, while the lateral is necessary for flight and active avoidance behaviour. Based on the experimental results, the possible etiology of enuresis, the relationship between this disorder and epilepsy, as well as emotional changes claimed to occur in enuretic patients, are discussed.