CLINICAL URO-NEUROPHYSIOLOGICAL INVESTIGATION IN MULTIPLE-SCLEROSIS

Subjective complaints of urinary dysfunction are common in multiple sc lerosis patients. Uro-neurophysiological investigation, namely somatos ensory evoked potentials (SEP) to stimulation of tibial and pudendal n erves, sacral reflex measurements and external anal sphincter electrom yography (EMG) were employed in a group of 21 patients with mild to mo derate multiple sclerosis and urinary symptoms. Tibial SEP showed abno rmality in 86% and pudendal SEP in 48% of patients. Sacral reflexes we re abnormal in 33% and external anal sphincter EMG showed abnormalitie s in 42% of patients (54% of women and 13% of men). Even in multiple s clerosis patients with urinary complaints tibial SEP seem to be more u seful in evaluating nervous system dysfunction than pudendal SEP. On t he other hand, abnormal pudendal SEP acconmpanied by normal tibial SEP may strengthen the suspicion of a conus lesion, the presence of which is some patients seems to be the cause of otherwise unexplained abnor malities of external anal sphincter EMG and sacral reflexes.