Increase of heat shock protein with exercise.

morning after overnight retention of urine. The anticholinergic effects of his drug treatment for schizophrenia may have been a contributing factor. Moreover, schizophrenic patients have been reported to have detrusor hypereflexia. Full bladder with possible outflow obstruction in presence of raised intraabdominal pressure during convulsions could have resulted in a ruptured bladder in our patient. The cystogram in our patient revealed the rent in the dome of the diaphragm. The bladder is protected anteriorly by pubic bone, inferolaterally by the urogenital diaphragm and obturator internus, leaving the dome unprotected, covered only by peritoneum. Our patient may have some similarity with two patients who developed bladder rupture following electroconvulsive therapy. In these patients, bladder rupture was attributed to powerful abdominal muscle contraction during an unmodified seizure on a distended bladder on a background of anticholinergic medication. U.K. Misra J. Kalita A. Vajpeyee Department of Neurology