Bulbocavernosus reflex, pudendal evoked potentials and tibial evoked potentials in multiple sclerosis

Abstract

Objective: In this study, the bulbocavernosus reflex (BCR), pudendal evoked potentials (PEP's) and tibial evoked potentials (TEP's) in 10 cases with the diagnosis of definite Multiple Sclerosis (MS), between the ages of 21-58 (Mean Age: 32.2) were investigated. In 8 of the 10 cases, an erectile impotence complaint was present.

Methods: In order to exclude clinical pictures that can cause impotence, detailed neurological and urological examinations were made in all the subjects. In all the patients, bulbocavernosus reflexes (obtained by stimulating the penis dorsal nerve and recording with a needle electrode from the bulbocavernosus muscle), pudendal evoked potentials (obtained by stimulating the penis dorsal nerve and recording from the scalp) and tibial somatosensory evoked potential (obtained by stimulating the posterior tibial nerve and recording from the scalp) were investigated. The results were compared with the normal values of Department of Neurophysiology Laboratory, and the values higher than the upper limit of the normal value (mean+2SD) were accepted as abnormal.

Results: TEP's and the PEP's were found to be abnormal in all patients in the study (100%); while the BCR’s in three patients with erectile impotence were abnormal. In the remaining 5 patients with impotence and the two patients without impotence complaints, the BCR latencies were found to be normal.

Conclusion: It was concluded that in the neurophysiological assessment of impotence in MS to aid the diagnosis, the BCR investigation is net a valuable method.

Keywords

• Bulbocavernosus reflex,pudendal evoked potentials and tibial evoked potentials in multiple sclerosis

References

1. Matthews WB. Symptoms and signs. In: Matthews WB, Compston A, Allen IV, Martyn CÏÏ eds. McAlpine's Multiple Sclerosis. Singapore: Churchill Livingstone, 1991 ,-98-99,280