4-aminopyridine improves lower urinary tract symptoms in a patient with benign prostatic hyperplasia and downbeat nystagmus syndrome.
Michael Leo StruppKatharina FeilStanislavs BardinsRaphaela WaidelichPublished in: International neurourology journal (2014)
Aminopyridines are potassium channel blockers that increase the excitability of nerve cells and axons; therefore, they are widely used to treat different neurological disorders. Here we present a patient with idiopathic downbeat nystagmus and lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia who was treated with the sustained-release form of 4-aminopyridine (4-AP). During treatment with 4-AP, the LUTS improved. This improvement was monitored by using uroflowmetry and the International Prostate Symptom Score. A significant improvement of symptoms was observed in relation to the voided volume. This included an improved emptying of the bladder without an increase in residual urine. In animal studies, both nonselective K(+) channel blockade and selective voltage-sensitive potassium blockade by 4-AP resulted in increased contraction on rat detrusor strips. To our knowledge, this is the first clinical observation of the mode of action of 4-AP in urological symptoms in humans.
Keyphrases
- benign prostatic hyperplasia
- lower urinary tract symptoms
- transcription factor
- case report
- induced apoptosis
- healthcare
- cell cycle arrest
- sleep quality
- spinal cord injury
- oxidative stress
- cell death
- urinary tract
- physical activity
- signaling pathway
- depressive symptoms
- transcranial direct current stimulation
- case control
- peripheral nerve