SYMPATHETIC SKIN-RESPONSES FROM THE FOOT AND THE HAND AND THEIR CONTRIBUTION TO THE DIAGNOSIS OF BLADDER NECK DYSSYNERGIA IN SPINAL-CORD INJURED PATIENTS

The purpose of this study was to assess the impairment of the descendi ng sympathetic spinal tract by sympathetic skin response recordings an d determine their effect on bladder neck function in patients with spi nal cord injury. The sympathetic skin responses (SSRs) of the right ha nd and foot were recorded and compared with the urodynamic findings in 27 spinal cord injury patients. All tetraplegic and paraplegic patien ts with a lesion above T6 who presented with bladder neck dyssynergia (END) had abnormal SSRs in the right hand and foot, All had bladder ne ck dyssynergia associated with autonomic hyperreflexia. All patients w ith a lesion below T6 and above T12 and abnormal SSRs in the right foo t also had END. Evidence is presented that the integrity of the descen ding sympathetic spinal tract is necessary for a synergic function of the vesico-urethral complex and that SSRs are of value in the diagnosi s of END. The rationale for further investigative methods to exclude E ND in lesions below T12 is presented.