The supraspinal control of colonic motility and anorectal motility is poorly documented. We had the opportunity to study colonic function, esophageal function, and urinary bladder function in three patients who presented with vascular lesions limited to the anterior (case 1) or the posterior area (cases 2 and 3) of the pons. Esophageal manometry, urodynamic examination, whole and segmental transit time measurements (using radiopaque markers) and anorectal motility were systematically performed. The results were the following: (1) in the first case esophageal motility was not altered, whereas abnormal micturition, right colonic inertia, and absence of rectoanal inhibitor reflex were observed; (2) in cases 2 and 3, there was a poor esophageal coordination, the micturition and rectoanal inhibitor reflex were normal, and the transit time of the left colon was increased. Our observations are consistent with the previously described localization of neurological areas controlling swallowing and micturition; they also favor the pons as the possible level of supraspinal control of colonic and anorectal motility.
Sutntnary. The authors describe a new therapy for paraplegic anejaculation.Sub-cutaneous injection of Physostigmine with certain precautions and with selected methods of application can be used for patients where there is the same indication for the use of an intrathecal injection of Neostigmine. The TI2-L2 myelomeres must be intact. The new treatment is easier to perform, and when the patient has experimented with three tests in our hospital without any problems, he is granted permission to apply this treatment at home, without any medical supervision.
The conclusion of this work is that the future of highly tetraplegic patients is compromised, especially for those who remain reliant on mechanical ventilation.
This document is part of a series of documents designed by the French Physical and Rehabilitation Medicine Society (SOFMER) and the French Federation of PRM (FEDMER). These documents describe the needs for or a specific type of patients; PRM care objectives, human and material resources to be implemented, chronology as well as expected outcomes. "Care pathways in PRM" is a short document designed to enable the reader (physicians, decision-maker, administrator, lawyer or finance manager) to quickly apprehend the needs of these patients and the available therapeutic care structures for proper organization and pricing of these activities. The patients after spinal cord injury are divided into five categories according to the severity of the impairments, each one being treated according to the same six parameters according to the International Classification of Functioning, Disability and Health (WHO), while taking into account personal and environmental factors that could influence the needs of these patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.