Bulbocavernosus Reflex and Pudendal Nerve Somatosensory Evoked Potential in a Cauda Equina Syndrome Patient with Only Lower Sacral Nerve Root Symptoms: A Case Report
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Cauda equina syndrome (CES) is a neurological condition involving low back pain, radiating pain, sensory loss, motor weakness, bladder dysfunction, and bowel dysfunction. A 37-year-old man was admitted with saddle-type hypesthesia, bladder dysfunction, and bowel dysfunction, but without motor weakness and radiating pain. He was diagnosed with large sequestrated lumbar disc herniation at L5-S1 and underwent decompression surgery. The initial bulbocavernosus reflex (BCR) and pudendal nerve somatosensory evoked potential (PSEP) on postoperative day 10 showed no response. After 1 month, bladder dysfunction and bowel dysfunction improved and saddle-type hypesthesia slightly improved. We also observed improvement in the BCR and PSEP during a follow-up evaluation on postoperative day 35. These results suggest that BCR and PSEP can indicate improvements in clinical symptoms and improved prognoses for CES patients with bladder dysfunction and bowel dysfunction.
Abstract
Cauda equina syndrome (CES) is a neurological condition involving low back pain, radiating pain, sensory loss, motor weakness, bladder dysfunction, and bowel dysfunction. A 37-year-old man was admitted with saddle-type hypesthesia, bladder dysfunction, and bowel dysfunction, but without motor weakness and radiating pain. He was diagnosed with large sequestrated lumbar disc herniation at L5-S1 and underwent decompression surgery. The initial bulbocavernosus reflex (BCR) and pudendal nerve somatosensory evoked potential (PSEP) on postoperative day 10 showed no response. After 1 month, bladder dysfunction and bowel dysfunction improved and saddle-type hypesthesia slightly improved. We also observed improvement in the BCR and PSEP during a follow-up evaluation on postoperative day 35. These results suggest that BCR and PSEP can indicate improvements in clinical symptoms and improved prognoses for CES patients with bladder dysfunction and bowel dysfunction.
참고문헌 (10)
- Kapetanakis S, "Cauda equina syndrome due to lumbar disc herniation : a review of literature", Folia Med(Plovdiv), 59, pp.377~386 (2017)
- Fraser S, "Cauda equina syndrome : a literature review of its definition and clinical presentation", Arch Phys Med Rehabil, 90, pp.1964~1968 (2009)
- Niu X, "Bulbocavernosus reflex and pudendal nerve somatosensory evoked potential are valuable for the diagnosis of cauda equina syndrome in male patients", Int J Clin Exp Med, 8, pp.1162~1167 (2015)
- Shapiro S, "Medical realities of cauda equina syndrome secondary to lumbar disc herniation", Spine(Phila Pa 1976), 25, pp.348~513 (2000)
- Hakan T, "The redundant nerve root syndrome of the Cauda equina", Turk Neurosurg, 18, pp.204~206 (2008)
- Celik EC, "Atypical presentation of cauda equina syndrome secondary to lumbar disc herniation", J Back Musculoskelet Rehabil, 25, pp.1~3 (2012)
- Orendácová J, "Cauda equina syndrome", Prog Neurobiol, 64, pp.613~637 (2001)
- Kennedy JG, "Predictors of outcome in cauda equina syndrome", Eur Spine J, 8, pp.317~322 (1999)
- Lee DG, "Prediction of the outcome of bladder dysfunction based on electrically induced reflex findings in patients with cauda equina syndrome : a retrospective study", Medicine(Baltimore), 96, pp.e701~e704 (2017)
- Niu X, "Bulbocavernosus reflex and pudendal nerve somatosensory-evoked potentials responses in female patients with nerve system diseases", J Clin Neurophysiol, 27, pp.207~211 (2010)