Bowel Function

Brainstem and spinal cord involvement along with autonomic peripheral neuropathy may result in alternating episodes of constipation or bowel incontinence. This type of constipation does not respond very well to laxatives or fiber since it reflects a widespread motility problem affecting the whole gut. Although rare, this condition suggests that autonomic dysfunction of gut motility is early evidence of sensory and motor neuropathy from peripheral or cranial nerve degeneration. ”This is rare, no familial form of slowly progressive neuropathy affecting some autonomic functions…Patients may have gastrointestinal dysfunction manifest many years before other peripheral sensory symptoms present.”     Updated: December 14, 2017 Sources: Superficial siderosis is a rare neurologic disease characterized by progressive sensorineural hearing loss, cerebellar ataxia, pyramidal signs, and neuroimaging findings revealing hemosiderin deposits in the spinal and cranial leptomeninges and subpial layer. The disease progresses slowly, and patients may present with mild cognitive impairment, nystagmus, dysmetria, spasticity, dysdiadochokinesia, dysarthria, hyperreflexia, and Babinski signs. Additional features reported include dementia, urinary incontinence, anosmia, ageusia, and anisocoria. Superficial siderosis MedGen UID: 831707 •Concept ID: CN226971 •Finding Orphanet: ORPHA247245 Living With SuperficialSiderosis Website PubMed Reference Library 

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Sexual Dysfunction (Female)

Superficial Siderosis female patient sexual dysfunction (FSD) is the result of autonomic peripheral neuropathy damage of the nerves in the pelvic and sacral regions. The most common problems include reduced libido, reduced vaginal lubrication, and difficulty achieving orgasm ¹. The female sexual function requires the interaction of areas of both the central and peripheral somatic and autonomic nervous system. There is a strong correlation between urinary incontinence and FSD. The sacral reflex arc and upper motor neurons must be intact for a woman to achieve orgasm and feel sexual desire. Cerebral sympathetic outflow is thought to increase desire, while peripheral parasympathetic activity results in clitoral vasocongestion and vaginal secretion (lubrication). The neurotransmitters for clitoral engorgement work the same way as for men. A fine network of vaginal nerves and arterioles control vaginal response. An intact sensation is required for arousal. Impaired levels of sexual functioning are more common in women with peripheral neuropathies than men. Just as a man who has erectile dysfunction due to autonomic peripheral neuropathy might need to turn to a penile vacuum device the same option is available for women with arousal and orgasmic difficulties. Superficial Siderosis patients might explore using a clitoral vacuum device. This handheld battery-operated device has a small soft…

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Sexual Dysfunction (Male)

Superficial Siderosis patient erectile dysfunction is the result of autonomic peripheral neuropathy damage of the nerves in the pelvic and sacral regions. This includes problems achieving or maintaining an erection or ejaculation problems stemming from small fiber nerve damage or sensory nerve dysfunction. Almost 38 percent of the 90 men recruited for the study, Peripheral neuropathy: an underdiagnosed cause of erectile dysfunction, were found to have polyneuropathy, which occurs when a number of the peripheral nerves throughout the body malfunction simultaneously. Of these nine percent had small fiber neuropathy, damage to the small unmyelinated peripheral nerve fibers and just over 14 percent had pudendal neuropathy, affecting the somatic nerve in the pelvic region. Researchers have uncovered clear links between erectile dysfunction (ED) and peripheral neuropathy. This study of 90 patients shows that men with more severe symptoms of peripheral neuropathy, which can be caused by disease, trauma or illness, had greater self-reported ED and required more aggressive treatment. The findings underline the importance of clinicians carrying out neurophysiological tests on patients with ED, particularly in the pelvic area.¹ Typically, men have two types of erections, psychogenic and reflex. A reflex erection is involuntary and can occur without sexual or stimulating thoughts.…

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Urinary Problems

Bladder function is controlled by the coordination of your autonomic nervous feedback system that loops between your bladder, spinal cord, and brain. Some nerves allow your conscious control of certain functions and others control involuntary actions. Urinary dysfunction is a common symptom of superficial siderosis patients. It often results from degeneration in the part of the brainstem that controls urination and small fiber autonomic neuropathy. S2, S3 and S4 nerves of your spinal cord control when the upper part of your bladder contracts, the bladder neck relaxes and the external urethral sphincter  (voluntary urination). Sympathetic nerves at the T11-L2 levels of the spinal cord cause the upper section of the bladder to relax and the bladder neck to contract, letting your bladder store urine. This is a voluntary function. These nerves are also responsible for keeping the internal urethral sphincter tightened so urine can not pass. This is an involuntary function. Incontinence, leakage, and increased urinary frequency are common problems when these nerves are affected. Parasympathetic nerves control the internal urethral sphincter. This is a reflex movement you can’t control. One of the ways bladder control fails is to not allow complete emptying of the bladder. When urine in your bladder hits around…

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