The existence of a brainstem region concerned with micturition has been known since the report of Barrington more than 70 years ago.1 In animals such a pontine micturition centre has been located in the dorsolateral tegmentum of the rostral pons, corresponding to Barrington’s micturition centre,2 but such a centre has not been precisely localised in humans. We describe a patient with presumed rhombencephalitis presenting with urinary retention and present his MRI findings. To our knowledge, this is the first MRI demonstration of a circumscribed lesion related to the putative pontine micturition centre in humans.

A 30 year old man with no history of voiding problems developed high fever, light headedness, frequent urination, and voiding difficulty. One day after onset, urinary retention occurred despite his sensation of needing to void. Two days later, in addition to urinary retention, the patient also had left cheiro-oral dysaesthesia and horizontal diplopia.Prostate examination did not show abnormalities. Urinary retention was managed with an indwelling catheter until 7 days after onset of his symptoms. The patient did not have a history of overdistension of the urinary bladder. Even though all his symptoms began to improve, the patient was referred to our hospital for an evaluation of neurological abnormalities.

Examination 9 days after onset showed mild right horizontal gaze paresis with …