33 KB105 KB27 KB192920262005Podnar, Simonštevilka:3letnik:74str. 153-157ISSN:1318-0347COBISSID:19255769URN:URN:NBN:SI:doc-1MXOKRRJslSlovensko zdravniško društvoZdravniški vestnikAnusCauda EquinaConstipationElectromyographyelektrodiagnostikaElektromiografijaFecal IncontinenceFekalna inkontinencaImpotencaImpotenceInjuriesiztrebljanjeKavda ekvinaLumbosacral PlexusLumbosakralni pletežmokrenjemotnjeNeurologic ExaminationNevrološka preiskavanevropatologijaObstipacijaperiferno živčevjesexual intercoursespolnostUrinary IncontinenceUrinska inkontinencaKrižna elektrodiagnostika v klinični praksi| Sacral electrodiagnostics in clinical practice|Background. Sacral electrodiagnostic (SED) studies are regarded as useful in patients with urinary, bowel or sexual dysfunction in whom peripheral sacral nervous system lesion is suspected. The aim of the present study was to present authors' experience with the referral pattern and findings of the SED testing. Methods. In the database of our neurophysiological laboratory, documentation of all examinees with SED studies performed by the author in theperiod from 1997-2002 was reviewed retrospectively. Neuropathic condition in the lower sacral segments was diagnosed using a quantitative electromyography (EMG) of the external anal sphincter (EAS) muscle. Data on examinees, specialties of referring doctors, referral diagnoses, symptoms and signs on neurological examiuation, aud SED findings were evaluated using descriptive, bivariate and multivariate statistics. Results. Altogether 193 patiertts (45% men), 7-83 years of age, were included. Urinary incontinence was reported by 99, urinary retention by 66 (both by 35) faecal incoutinence by 73, constipation by 53 patients, sexual dysfunction by 49 (data available for 92 patients), and several sacral symptoms by 100 patients. On clinical examination 54 patients had signs of lower limb focal neuropathies, and 47 patients had perineal sensory loss. Pathological quantitative EMG of the EAS was found in 85 (44%) patients (cauda equina lesion in 28, multiple system atrophy iu 10, etc.). On ordinal logistic regression analysis were significantly related to neuropathic EMG abnormalities particularly urinary retention and perineal sensory loss. Conclusions. The present study revealed neuropathic abnormalities in slightly less than a half of patients referred toSED testing. No definite guidelines for referral to SED testing could be defined, but patients with urinary retention and perineal sensory loss seem more likely to prove to have neuropathic abnormalities in lower sacral segmentsIzhodišča. Križne elektrodiagnostične preiskave (KEDP) so smiselne pri bolnikih z motnjami mokrenja, iztrebljanja in spolne dejavnosti, pri katerih sumimo na okvaro perifernega živčevja. Namen raziskave je bil predstaviti avtorjeve izkušnje z napotitvami in najdbami KEDP. Metode. V arhivu lnštituta za klinično nevrofiziologijo v Ljubljani smo pregledali dokumentacijo o vseh bolnikih, pri katerih je avtor v letih 1997-2002 opravil KEDP. Diagnozo nevropatske prizadetosti spodnjih križnih segmentov smo postavili na osnovi rezultatov kvantitativne igelne elektromiografije (EMG) zunanje zapiralke zadnjika (ZZZ). Za analizo podatkov o preiskovancih, specializiranosti napotnih zdravnikov; napotnih diagnozah, simptomih in znakih pri kliničnem nevrološkem pregledu in najdbah KEDP smo uporabili metode opisne, bivariatne in multivariatne statistike. Rezultati. Vključili smo 193 bolnikov (45% moških), starih 7 do 83 let. Uhajanje seča je navajalo 99, zastanek seča 66 (oboje 35), uhajanje blata 73, zaprtje 53, moteno spolnost 49 (podatki na voljo pri 92 bolnikih) in več križnih simptomov 100 bolnikov. Pri kliničnem nevrološkem pregledu je imelo 57 bolnikov znake žariščne prizadetosti perifernega živčevja spodnjih udov in 47 motnje senzibilitete perinealno. Patološki kvantitativni EMG ZZZ smo našli pri 85 (44%) bolnikih (poškodbe kavde ekvine pri 28, multiplo sistemsko atrofijo pri 10 itd.). Pri ordinalni logistični regresiji sta bila značilna napovedna dejavnika za nevropatski EMG predvsem zastanek seča in motnje senzibilitete perinealno. Zaključki. S KEDP smo našli nevropatske abnormnosti pri slabi polovici napotenih bolnikov. Čeprav na osnovi naših rezultatov ne moremo definirati kliničnih meril za napotitev na KEDP, s katerimi bi lahko napovedali nevropatske spremembe v spodnjih križnih segmentih pri vseh bolnikih, lahko zaključimo, da so primernikandidati za KEDP predvsem bolniki z zastankom seča in perinealnimi motnjami senzibiliteteTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo