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D B Vodusek

Publications and source records attributed to D B Vodusek.

51 records · Page 3Linked to original sources
PubMed1993

Activity patterns of pubococcygeal muscles in nulliparous continent women.

Simultaneous electromyographic (EMG) recordings from the left and right pubococcygeal muscles were obtained in 10 continent nulliparous women (aged 22-32 years) via wire electrodes inserted percutaneously. During relaxation, sustained motor unit firing was obtained in 14 and no EMG activity in 4 of the 20 recorded muscle sites. During voluntary squeeze, stopping urine in midstream and coughing there was always bilateral recruitment of motor units that was gradual in the recording sites with ongoing EMG activity and brisk in the sites without EMG activity; the 2 different patterns of activity were called "tonic" and "phasic" respectively. Voluntary squeeze led to activation of motor units sustained for 26 to 647 s (median 193.9) with the bladder empty and 25 to 600 s (median 198.4) with a full bladder. A marked decrease in ongoing tonic motor unit activity was seen during the attempt to urinate. Bladder filling caused an increase in tonic activity in 7 females bilaterally and in 1 unilaterally, whereas there was no change in 3 women. During the Valsalva manoeuvre, simultaneous motor unit recruitment was seen in all subjects bilaterally with the bladder empty and in all but one with the bladder full: in the latter case the motor unit recruitment with an empty bladder changed into simultaneous bilateral inhibition of firing of motor units with a full bladder (both in the supine and erect position); this pattern changed to bilateral recruitment of motor units again after bladder emptying. It is important to be familiar with the normal patterns of activity of the pubococcygeal muscles in continent nulliparous women since the denervation injury caused by childbirth might not only weaken these muscles but also influence their behaviour.

Adult↗
PubMed1993

Lithium and peripheral nervous system function in manic-depressive patients.

INTRODUCTION: Lithium salts are widely used in treatment of affective disorders, but lithium may cause electrophysiologically detectable changes in peripheral nervous system even with lithium concentrations within recommended therapeutic limits. The risk of lithium treatment against other risks to peripheral nervous system in psychiatric patients with affective psychoses was tested in our study. MATERIAL AND METHOD: Electrophysiologic parameters of motor and sensory peripheral nerve fibre function were measured in two age-matched groups of psychiatric patients (20 lithium-treated and 20 affective psychotic patients without lithium treatment) and a group of 20 healthy age-matched volunteers. RESULTS: Lower amplitudes of M waves (p < 0.015) and sensory nerve action potentials (p < 0.020) on stimulation of the median nerve have been found in both groups of patients. On peroneal nerve stimulation lower M wave amplitudes have been found only in the group of lithium-treated patients (p < 0.055). No significant differences in conduction parameters of motor and sensory fibres were demonstrated. CONCLUSION: Our results demonstrate subclinical involvement of motor and sensory axons in affective-psychotic patients, which is only slightly more pronounced in lithium-treated patients. We suggest that lithium (within therapeutic plasma concentrations) is just one among the factors leading towards minor axonopathy in psychiatric patients.

Adult↗
PubMed1993

Pudendal versus limb nerve electrophysiological abnormalities in diabetics with erectile dysfunction.

It is of some interest to diagnose polyneuropathy and/or sacral neuropathy in diabetic males with erectile dysfunction. Non-invasive electrophysiological measurements with surface electrodes, which are widely available, have been applied to determine the diagnostic yield of several electrophysiologic parameters for assessing polyneuropathy including the pudendal nerve in impotent diabetics. Latencies of the bulbocavernosus reflex and the pudendal somatosensory evoked potentials were measured in a group of 28 diabetic patients with an erectile dysfunction as their main complaint, as well as in a group of 20 potent males without systemic disease. In diabetic patients motor conduction measurements of one median and peroneal nerve and sensory conduction measurements of one median and sural nerve were also performed. In 15 patients abnormalities of the peripheral nerve conduction were demonstrated whereas abnormalities of the bulbocavernosus reflex and/or cortical somatosensory evoked potentials were demonstrated in eight. Five patients had both types of abnormalities. In the patient group no differences could be demonstrated between those with Type 1 or Type 2 diabetes. The only significant clinical/neurophysiological correlation was found between the absence of the bulbocavernosus reflex on clinical examination and its prolonged latencies on electrophysiological measurement. The study showed that a bigger yield of abnormal results was obtained when pudendal nerve function parameters were included in the evaluation of diabetics with erectile dysfunction. Considered separately, however, the battery of electrophysiological tests evaluating limb nerve function seems more sensitive in diagnosing neuropathy than electrophysiological assessment of pudendal nerve function alone.

Adult↗
PubMed1992

Intraoperative monitoring of the dorsal sacral roots: minimizing the risk of iatrogenic micturition disorders.

In 31 children (age, 2-17 years) and 1 adult, individual dorsal root action potentials (DRAPs) from the S1-S3 roots were recorded intraoperatively after electrical stimulation of the dorsal penile or clitoral nerves, in preparation for surgery within the cauda equina. In most patients, pudendal afferent activity was present in S2 and S3 bilaterally; in some, the afferent activity was confined to a single root bilaterally, and in one, to a single root on one side. Dorsal root action potentials of small amplitude were recorded from S1 in 15 patients, although in no patient was S1 the primary carrier of these afferents. No lesion of the roots or rootlets carrying significant afferent activity was created during the rhizotomy, and no dysfunction in micturition resulted. We propose that the neurophysiological identification of roots and rootlets carrying afferent activity from the penile or clitoral nerves allows for rhizotomy of the S2 roots with the least possible risk of postoperative micturition and sexual dysfunction.

Adolescent↗
PubMed1990

The bulbocavernosus reflex. A single motor neuron study.

Reflex latency variability was established for single motor neuron discharges in the bulbocavernosus reflex, as elicited by electrical stimuli to the dorsal penile nerve and recorded by a single fibre EMG electrode in the bulbocavernosus muscle. Whereas many reflex responses had a rather large latency variability of above 1000 microseconds (expressed as SD of mean latency) there was a group of motor neurons with a variability of around 500 microseconds. Single motor neuron reflex responses with shorter latencies tended to show less variability. No habituation of single motor neuron reflex discharges was observed on prolonged regular repetitive stimulation. Both absence of habituation and the relatively low latency variability of bulbocavernosus reflex responses for single motor neurons suggest similarities between this reflex and the first component of the blink reflex; we postulate that the shortest bulbocavernosus reflex pathway is oligosynaptic.

Adult↗
PubMed1988

Facioscapulohumeral dystrophy: jitter in facial muscles.

Motor end plate jitter was studied by single fibre EMG in the orbicularis oculi muscle of eight patients with facioscapulohumeral dystrophy activated by extramuscular nerve stimulation. The jitter was found to be slightly larger in comparison with the normal controls, although still within the normal limits in each patient. The findings are considered to indicate absence of any significant neuromuscular transmission disturbance, inflammatory or regenerative process, or reinnervation in progress. There was no evidence of muscle fibre conduction abnormality even in very weak muscle.

Adolescent↗
PubMed1987

Pudendal nerve involvement in patients with hereditary motor and sensory neuropathy.

Pudendal nerve involvement was demonstrated by electromyography of perineal muscles and by recordings of their direct and reflex responses on perineal electrical stimulation in 10 patients with hereditary motor and sensory neuropathy. Patients reported no defecation disturbances and the 6 men had good erections. Urinary stress incontinence was seen in those 2 (of 4) female patients who had delivered.

Adolescent↗
PubMed1983

Direct and reflex responses in perineal muscles on electrical stimulation.

Responses in the external anal and urethral sphincters as well as in the bulbocavernosus muscle have been evoked by supramaximal electrical stimulation of the penis (or clitoris), perineum and the peri-anal region and recorded electromyographically in 82 male subjects 5 to 73 years old and in nine female subjects 18 to 55 years old, who had no systemic diseases or demonstrable sacral nervous system lesion. On perineal stimulation (including the penis or clitoris) reflex responses with a typical latency of 33 ms and which exhibit no habituation were obtained in all muscles examined. Stimulation of the peri-anal region gave habituating reflex responses with a typical latency of 55 ms in all muscles examined. On perineal, and sometimes also peri-anal stimulation, stable short latency responses with typical latencies of 5 and 13 ms were recorded; both were considered to be direct responses. The different evoked muscle responses obtained by stimulation in the perineal and peri-anal region have to be distinguished when the bulbocavernosus and anal reflexes are recorded for evaluation of sacral nervous system lesions.

Adolescent↗
PubMed1982

EMG, single fibre EMG and sacral reflexes in assessment of sacral nervous system lesions.

EMG of pelvic floor muscles, single fibre EMG of external anal sphincter and both bulbocavernosus and anal reflexes were investigated in 31 men without sacral nervous system lesions and in 12 patients with neurogenic erectile impotence, of whom one had slight loss of sensitivity to pinprick in the lower sacral dermatomes. EMG and single fibre EMG abnormalities have been found concomitantly in eight patients and six of these had also prolonged bulbocavernosus reflex latencies. In two patients the prolonged bulbocavernosus reflex latency was the only abnormality. Single fibre EMG of anal sphincter muscle seems to be superfluous in routine evaluation of sacral nervous system lesions.

Adolescent↗
PubMedDate not supplied

Pudendal SEP and bulbocavernosus reflex in women.

A new simple method for the electrical stimulation of the dorsal nerve of clitoris is presented. Well-formed cortical somatosensory evoked potentials could be recorded in 12 continent adult females without nervous system involvement at a stimulus intensity of 4 times 'sensory threshold.' The procedure was well tolerated by the subjects; the bulbocavernosus reflex responses were, however, not always obtainable at this stimulus intensity.

Adolescent↗
PubMedDate not supplied

Autonomic system dysfunction in moderate diabetic polyneuropathy assessed by sympathetic skin response and Valsalva index.

30 patients with moderate diabetic polyneuropathy (Stage 2 according to Dyck) were evaluated for autonomic symptoms, sympathetic skin response (SSR) and Valsalva index. Their SSR were compared to a control group of 30 healthy normal subjects. Neuropathy was confirmed by history, clinical examination and nerve conduction measurements. Although our patients had only moderate polyneuropathy autonomic dysfunction was frequent. Two thirds reported autonomic symptoms. Impotence was present in 60% of males. SSR amplitudes were significantly lower in diabetics (changed in 53%, absent in 20%) than in the controls. SSR abnormality correlated to some clinical and electroneurographic signs of neuropathy, suggesting similar affection of sympathetic and somatic fibres. Valsalva index was abnormal in 37% of patients showing no correlation to clinical, electroneurographic or SSR changes.

Adult↗