Motor evoked potentials from the pelvic floor

Brostrøm, Søren

doi:10.1002/nau.10151

Cited by 29 publications

(8 citation statements)

References 95 publications

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“…On one hand, a direct EUS response is possible as well as re£ex EUS response via the a¡erent pathways. Most of the data are published for EMG recordings after magnetic stimulation [Brostrom, 2003]. Brodak et al [1993] reported about latencies of the EUS and MEP of the bulbocavernosal muscle in spinal cord injured patients.…”

Section: Discussionmentioning

confidence: 98%

“…Motor latencies to the pelvic £oor could be established which range around 4^10 msec [Opsomer et al, 1989;Vodusek, 1996;Brostrom, 2003] for the electromyographic response depending on the method (surface or needle electrodes, electrical or magnetic stimulation, location of stimulation) and around 27 msec for the urethral pressure response [Schmid et al, 2001].…”

Section: Discussionmentioning

confidence: 99%

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Conditioning stimulus can influence an external urethral sphincter contraction evoked by a magnetic stimulation

Wefer

Reitz

Knapp

et al. 2005

Neurourology and Urodynamics

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A conditional sensory pudendal stimulation seems to have the capacity to inhibit the external urethral sphincter contraction induced by a magnetic stimulation. The inhibitory effect seems to depend on the latency between the peripheral and lumbosacral stimulation as well as on the degree of BLA filling. It remains to be proved if the neuromodulative effect of the conditional stimulus occurs at a spinal or supraspinal level.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Conditioning stimulus can influence an external urethral sphincter contraction evoked by a magnetic stimulation

Wefer

Reitz

Knapp

et al. 2005

Neurourology and Urodynamics

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“…In order to determine the sites responsible for the urinary retention in such cases, urological as well as neurological, neurophysiological, and imaging studies are necessary; these studies should include the pelvic nerves (sacral herpes), spinal conus, spinal cord (MRS, ADEM), the pontine micturition centre (PMC) (multiple sclerosis, herpetic brainstem encephalitis), and rarely, the medial frontal lobe. Sacral magnetic stimulation might help to detect any direct involvement of the pelvic nerves [45].…”

Section: Acute Urinary Retention With Csf Abnormality Alonementioning

confidence: 99%

Acute urinary retention due to benign inflammatory nervous diseases

et al. 2006

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Both neurologists and urologists might encounter patients with acute urinary retention due to benign inflammatory nervous diseases. Based on the mechanism of urinary retention, these disorders can be divided into two subgroups: disorders of the peripheral nervous system (e.g., sacral herpes) or the central nervous system (e.g., meningitis-retention syndrome [MRS]). Laboratory abnormalities include increased herpes virus titers in sacral herpes, and increased myelin basic protein in the cerebrospinal fluid (CSF) in some cases with MRS. Urodynamic abnormality in both conditions is detrusor areflexia; the putative mechanism of it is direct involvement of the pelvic nerves in sacral herpes; and acute spinal shock in MRS. There are few cases with CSF abnormality alone. Although these cases have a benign course, management of the acute urinary retention is necessary to avoid bladder injury due to overdistension. Clinical features of sacral herpes or MRS differ markedly from those of the original "Elsberg syndrome" cases.

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“…Les PEM permettent d'étudier la commande motrice des sphincters ou des muscles du plancher pelvien en enregistrant les réponses EMG à la stimulation magnétique transcrânienne du cortex moteur [26][27][28][29][30][31]. Les temps de conduction sont plus fiables que les valeurs absolues d'amplitude des réponses motrices générées.…”

Section: Potentiels éVoqués Moteurs (Pem)unclassified

“…L'examen est généralement complété par la mesure des LDM en réponse à la stimulation des racines sacrées, ce qui permet de distinguer un temps de conduction « périphérique » (entre les trous sacrés et le muscle où s'effectue le recueil) et un temps de conduction « centrale » (qui comprend les temps de conduction intraencéphalique, médullaire, mais aussi radiculaire intracanalaire). Le recueil peut s'effectuer par électrodes de surface ou à l'aiguille, mais compte tenu de l'activation concomitante des muscles fessiers, un enregistrement à l'aiguille serait plus sélectif et devrait être recommandé [31]. Cette technique permet en théorie de documenter une atteinte centrale supra-sacrée ou de la moelle sacrée qui se manifeste par un allongement du temps de conduction « centrale » aux dépens du temps de conduction « périphérique ».…”

Section: Potentiels éVoqués Moteurs (Pem)unclassified

Exploration neurophysiologique périnéale des atteintes de la queue-de-cheval et du cône terminal

Ahdab

Lefaucheur

2010

Pelv Perineol

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Le syndrome de la queue-de-cheval résulte de lésions concomitantes (généralement d'origine compressive) de plusieurs racines sacrées et/ou lombaires dans le canal rachidien, alors que le syndrome du cône terminal correspond à l'atteinte des structures centrales médullaires sacrées. Ces deux entités sont proches sur le plan de leur expression clinique, leurs symptômes comprenant notamment des troubles mictionnels et une anesthésie en selle. Même si le tableau clinique est complet et typique, le bilan radiologique (imagerie par résonance magnétique) est incontournable, en particulier pour établir le diagnostic étiologique. En complément de l'imagerie, le bilan électrophysiologique peut être justifié pour confirmer le diagnostic, notamment en cas de discordance clinicoradiologique, pour mieux comprendre la physiopathologie des lésions et en apprécier la sévérité fonctionnelle, voire le pronostic. Dans ce texte, nous détaillons plus spécifiquement les techniques applicables dans le cadre du bilan électrophysiologique périnéal : électromyographie de détection à l'aiguille, mesure des latences distales motrices, potentiels évoqués moteurs et somesthésiques, réponses réflexes sacrées et cutanées sympathiques, quantification des seuils de sensibilité. L'utilité et les limites de ces techniques seront discutées, notamment dans le cadre du diagnostic différentiel qui reste difficile à établir entre atteinte du cône terminal et de la queue-de-cheval.Mots clés Cône terminal · Électromyographie · Latence distale motrice · Potentiel évoqué · Quantification des seuils de sensibilité · Queue-de-cheval · Réflexe sacré · Réponse cutanée sympathique Abstract Cauda equina syndrome results from concomitant lesions of several sacral or lumbar roots within the spinal canal, whereas sacral conus syndrome more specifically relates to the damage of central nervous structures within the sacral spinal cord. Both entities have close but heterogeneous clinical presentation, including voiding disturbances and saddle anesthesia. Radiological investigation (magnetic resonance imaging) is required, at least to assess the etiology of the lesions, even if clinical features leave no room for doubt concerning the diagnosis. Electrophysiological examination is complementary to imaging and can be useful to confirm the diagnosis, to better understand the underlying mechanisms, to assess the severity of the damage, or to establish a prognosis of recovery at the follow-up. In this article, we describe the various techniques that are more specifically applicable in the electrophysiological investigation of the perineum: needle electromyography, terminal motor latency measurement, motor and somatosensory evoked potentials, sacral and sympathetic skin reflex responses, and quantitative sensory testing. The utility and limitations of these techniques will be discussed, in particular regarding the differential diagnosis between cauda equina and sacral conus syndrome, which is usually hard to establish.

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Motor evoked potentials from the pelvic floor

Cited by 29 publications

References 95 publications

Conditioning stimulus can influence an external urethral sphincter contraction evoked by a magnetic stimulation

Conditioning stimulus can influence an external urethral sphincter contraction evoked by a magnetic stimulation

Acute urinary retention due to benign inflammatory nervous diseases

Exploration neurophysiologique périnéale des atteintes de la queue-de-cheval et du cône terminal

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