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Meningomyelocele: a clinical, urodynamic and neurophysiological evaluation
The Journal of Urology
|April 1, 1984
Summary
Neurophysiological evaluation in children with meningomyelocele helps determine lesion levels. Findings correlate detrusor activity with reflex arc function, aiding in understanding lower motor neuron lesions.
Area of Science:
- Neuroscience
- Urology
- Pediatric Neurology
Background:
- Meningomyelocele often results in complex lumbosacral spinal cord lesions.
- Understanding the precise level and type of lesion is crucial for managing bladder and bowel dysfunction.
Purpose of the Study:
- To correlate neurophysiological findings with urodynamic data in children with meningomyelocele.
- To further define the level and type of lumbosacral spinal lesion.
- To assess the utility of various neurophysiological methods.
Main Methods:
- Clinical neurological, urodynamic, and neurophysiological evaluations were performed on 11 children.
- Electromyography (EMG) assessed denervation.
- Bulbocavernosus reflex and somatosensory evoked potentials were evaluated.
Main Results:
- Detrusor hyperreflexia was observed in 45% of patients.
- Functional or interrupted somatic sacral reflex arcs were identified.
- EMG showed severe partial to complete denervation, with some preserved activity.
- Bulbocavernosus reflex was often absent but not always indicative of complete interruption.
- Somatosensory cortical evoked potentials were useful; lumbosacral evoked potentials were less so.
Conclusions:
- Urodynamic and neurophysiological evaluations are valuable for documenting bladder and sphincter function, even with apparent complete lower motor neuron lesions.
- These methods help elucidate the complexity of meningomyelocele-related spinal cord lesions.
- Findings highlight the importance of a multimodal approach in assessing these patients.