Brostrom S, Frederiksen J L, Jennum P, Lose G
Department of Gynecology-Obstetrics, Glostrup Hospital, DK-2600 Glostrup, Denmark.
J Neurol Neurosurg Psychiatry. 2003 Apr;74(4):498-500. doi: 10.1136/jnnp.74.4.498.
The use of motor evoked potentials (MEPs) to study the integrity of pelvic floor motor innervation is poorly described in the literature. This study evaluated the clinical use of pelvic floor MEPs in 16 women with multiple sclerosis. Lower urinary tract dysfunction was assessed with urodynamic investigations. Transcutaneous magnetic stimulation was applied over the motor cortex and spinal roots, and MEPs were recorded from the puborectalis, the external urethral sphincter, and the abductor hallucis muscles. In many patients, responses from the pelvic floor muscles could not be evoked, and central motor conduction times for the puborectalis motor pathways could only be calculated in 56%. There was a poor correlation of abnormal conduction to lower urinary tract dysfunction. It is concluded, that unevokable responses from pelvic floor muscles in a patient with multiple sclerosis should be interpreted with care, and that pelvic floor MEPs have a limited clinical value in the investigation of suspected demyelinating disease.
运动诱发电位（MEPs）用于研究盆底运动神经支配完整性的相关内容在文献中描述甚少。本研究评估了盆底MEPs在16例多发性硬化症女性患者中的临床应用。通过尿动力学检查评估下尿路功能障碍。经皮磁刺激应用于运动皮层和脊髓神经根，并从耻骨直肠肌、尿道外括约肌和拇展肌记录MEPs。在许多患者中，无法诱发出盆底肌肉的反应，耻骨直肠肌运动通路的中枢运动传导时间仅在56%的患者中能够计算。异常传导与下尿路功能障碍之间的相关性较差。得出的结论是，对于多发性硬化症患者盆底肌肉无法引出的反应应谨慎解读，并且盆底MEPs在疑似脱髓鞘疾病的检查中临床价值有限。
