Experience with Electromyography of the External Urethral Sphincter in Spinal Cord Injury Patients

Koyanagi, Tomohiko; Arikado, Katsuhisa; Takamatsu, Tsuneo; Tsuji, Ichiro

doi:10.1016/s0022-5347(17)53739-8

Cited by 37 publications

(17 citation statements)

References 14 publications

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“…Slight elevation of serum creatinine was found in 1 child with failure to thrive and urinary retention (case 10). On physical examination, lumbosacral and/or leg abnormalas described previously [10]. Renoscintigraphy, cystourethroscopy and computerized tomography (CT) were added when necessary.…”

Section: Methodsmentioning

confidence: 99%

Diagnosis and Management of Sacral Agenesis

Gotoh¹,

Shinno²,

Kobayashi³

et al. 1991

Eur Urol

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Section: Methodsmentioning

confidence: 99%

Diagnosis and Management of Sacral Agenesis

Gotoh¹,

Shinno²,

Kobayashi³

et al. 1991

Eur Urol

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“…However, the BCR per se cannot evaluate the degree of impaired conus/cauda function. 3 Electromyographic (EMG) recordings are the most sensitive diagnostic tool available in the assessment of lesions of the peripheral motor nerves, ie from the anterior horn cells located in the conus medullaris and the peripheral motor nerve ®bres of the cauda equina. The main disadvantage of this technique is, that EMG is less sensitive in quantifying the degree of damage to peripheral motor nerve ®bres in the acute lesion.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic and prognostic value of compound motor action potential of lower limbs in acute paraplegic patients

2000

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Objectives: To evaluate the diagnostic and prognostic contribution of motor nerve conduction studies (NCS) in addition to neurological examination in patients with acute paraplegia. Methods: In 79 patients with acute onset of paraplegia due to traumatic or ischaemic damage of the conus medullaris/cauda equina (conus/cauda) or lesion of the mid-thoracic spinal cord (epiconal) neurological (initial and follow-up clinical motor and sensory scores; outcome of ambulatory capacity determined at least 6 months post-trauma) and electrophysiological examinations (motor nerve conduction velocity (MNCV) and compound motor action potential (CMAP) of tibial and peroneal nerves) were performed in parallel. Results: Severe axonal motor neuropathies were signi®cantly caused by conus/cauda lesions (loss of tibial CMAP in 71% and of peroneal CMAP in 68%) compared to patients with epiconal lesion (no loss of tibial CMAP and abolished peroneal CMAP in 14%). The CMAPs were deemed acutely pathological 4 ± 14 days post-trauma and were indicative of the severity of conus/cauda lesion while the MNCV remained normal. Follow-up recordings (up to 1 year post trauma) revealed no signi®cant change in the CMAP values. The clinical examination according to the American Spinal Injury Association (ASIA protocol) in contrast to the CMAP values was signi®cantly related to the outcome of ambulatory capacity. Conclusions: In contrast to patients with an epiconal SCI almost all patients with damage of the conus/cauda present a severe axonal neuropathy of the tibial and peroneal nerves. Pathological CMAPs develop as early as 1 ± 2 weeks after onset of acute paraplegia. They allow, at an early stage, to di erentiate between conus/cauda or epiconal lesion and to assess the severity of conus/cauda lesion. Thereafter follow-up examinations remain stable and a developing worsening of peripheral nerve or spinal cord function, eg due to post-traumatic syringomyelia, may be indicated by a secondary deterioration of CMAP values. The clinical examination, according to the ASIA protocol, in acute paraplegia patients, in contrast to the motor nerve conduction studies, is of prognostic value in predicting the outcome of ambulatory capacity.

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“…The effect of IX blocking agents, advised by Buczynski 1984 in early treatment, and by Koyanagi et al (1982) in the minor degrees of dyssynergia was not tried out by us. In the literature many important arguments are given against a sympathetic innervation of the external striated urethral sphincter (Rossier et al, 1983).…”

Section: Specific Treatment For the Sphincter Dyssynergiamentioning

confidence: 97%

“…It is preferable to investigate the urethral external sphincter itself with EMG as discordant activities between this muscle and the anal sphincter were noted in up to 39°0 of the patients (Koyanagi et al, 1982).…”

Section: Specific Treatment For the Sphincter Dyssynergiamentioning

confidence: 99%

Urethral sphincter dyssynergia in spinal cord injury patients

Wyndaele

1987

Spinal Cord

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SummaryOn the basis of several hundreds of urodynamic investigations done in 105 SCI patients the phenomenon of urethral sphincter dyssynergia was studied.In Upper Motor Neuron Lesion (UMNL) patients, dyssynergic contractions of the external urethral sphincter during spontaneous bladder contractions were dem onstrated in 86°0 and, during bladder contractions initiated by suprapubic tapping, also in 86°0• CREDE manoeuvre or abdominal straining gave an augmentation of the urethral sphincter activity in 53°o. Interrupted tapping could lower a dyssy nergic sphincter activity in a great number of UMNL patients. This technique of bladder stimulation was important to acquire a balanced bladder function in 28�o of the patients.In patients with a non-contracting detrusor, a non-relaxing sphincter or aug mentation of the sphincter spasticity with the cride manoeuvre or abdominal straining was found in at least 50 0 0• The values of different forms of conservative treatment and of sphincterotomy are discussed. The final outcome of the bladder re education is given.

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Experience with Electromyography of the External Urethral Sphincter in Spinal Cord Injury Patients

Cited by 37 publications

References 14 publications

Diagnosis and Management of Sacral Agenesis

Diagnosis and Management of Sacral Agenesis

Diagnostic and prognostic value of compound motor action potential of lower limbs in acute paraplegic patients

Urethral sphincter dyssynergia in spinal cord injury patients

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