Author/Editor		Vodušek, David B
Title		Electrophysiological diagnostics in neurogenic disorders of micturition, defecation and sexual function
Type		članek
Source		In: Kimura J, Shibasaki H, editors. Recent advances in clinical neurophysiology. Proceedings of the 10th international congress of EMG and clinical neurophysiology; 1995 Oct 15-19; Kyoto. Amsterdam: Elsevier science,
Publication year		1996
Volume		str. 649-54
Language		eng
Abstract		Several uroneurophysiological tests have been applied in research on groups of patients revealing neurogenic aspects of lower urinary tract, anorectal and sexual dysfunction. There is still little consensus which of these methods are also helpful in diagnostic evaluation of individual patients with putative neurogenic sacral dysfunction. According to a review of literature and personal experience the concentric needle EMG of pelvic floor muscles, sacral reflex and cerebral somatosensory evoked potentials (SEP) on electrical stimulation of the dorsal penile/clitoral nerve, and revording of sympathetic skin responses from perineal skin give reproducible results on control subjects, and are robust methods when applied in patients. EMG is the single most important method to diagnose a lower motor neuron lesion in the lower sacral segments, and the other tests help to localise and characterise the lesion. In pelvic floor muscles abnormal spontaneous activity, mean motor unit potential duration above 9.2 ms, and the percentage of polyphasic potentials above 33% are considered abnormal if at least 10 motor unit potentials have been analysed per muscle (half of sphincter). latency of sacral reflex above 45 ms, and P40 latency of cerebral SEP above 50 ms are considered abrnomal. An absence of sacral reflex, cerebral SEP, or sympathetic skin response are considered abnormal. Further research will clarify the diagnostic strength of motor evoked potentials in perineal muscles, and sacral reflexes as well as cerebral SEP on electrical stimulationof visceral afferents.
Descriptors		URINATION DISORDERS DEFECATION SEX DISORDERS EVOKED POTENTIALS, SOMATOSENSORY ELECTROMYOGRAPHY PELVIC FLOOR LUMBOSACRAL PLEXUS REFLEX