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Imidapril, an angiotensin-converting enzyme inhibitor, can reverse loss of bladder sensation
  1. R Sakakibara1,
  2. C Yamaguchi2,
  3. T Yamamoto3,
  4. T Uchiyama3,
  5. Z Liu3,
  6. T Ito3,
  7. Y Awa3,
  8. K Yamamoto3,
  9. M Kinou3,
  10. T Hattori4
  1. 1Department of Neurology, Chiba University, Chiba, Japan
  2. 2Central Laboratory Unit, Chiba University
  3. 3Department of Neurology, Chiba University
  4. 4Department of Urology, Chiba University
  5. 5Department of Neurology, Chiba University
  1. Correspondence to:
 Dr Ryuji Sakakibara
 Neurology Department, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan; sakakibara{at}

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Loss of bladder sensation (LBS), which can occur in sensory neuropathy or spinal cord lesion, is not well known.1 Patients with LBS have to perform scheduled voiding to avoid overdistension bladder injury, resulting in a significant burden on patients. The cure of LBS, however, has proved to be difficult. Clinical evidence suggests that the angiotensin-converting enzyme (ACE) inhibitor is beneficial for restoring decreased airway sensation and swallowing reflex in the elderly2 and for preventing silent aspiration pneumonia.3

We recently treated a patient with LBS who responded to treatment with an ACE inhibitor. A 32-year-old woman had multiple sclerosis for the past 3 years: the initial episode occurred when she was 30; she developed visual field loss, headache and dysarthria, followed by right hemiparesis and left facial and hypoglossal palsies. A brain MRI scan showed multiple plaques as well as CSF abnormalities. …

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  • Competing interests: None declared.

  • Informed consent was obtained from the patient described in this report.