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Modulation of the bulbocavernosus reflex during voiding: Loss of inhibition in upper motor neuron lesions
Author(s) -
Sethi Rajesh K.,
Bauer Stuart B.,
Dyro Frances M.,
Krarup Christian
Publication year - 1989
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.880121104
Subject(s) - bulbocavernosus reflex , motor neuron , reflex , neuroscience , medicine , electromyography , h reflex , lower motor neuron , modulation (music) , upper motor neuron , physical medicine and rehabilitation , psychology , spinal cord , physics , amyotrophic lateral sclerosis , disease , acoustics
The bulbocavernosus reflex (BCR) is a sacral segmental reflex which is suppressed throughout most of micturition. The BCR was evaluated by recording the associated EMG activity using a concentric needle electrode placed in the external urethral sphincter. The influence of the central nervous system (CNS) on the BCR was studied in 29 neurologically normal individuals and in 33 patients with upper motor neuron (UMN) lesions and voiding dysfunction. Ninety percent (26/29) of the neurologically normal patients did not have a BCR during most of micturition. By comparison, all the patients with an UMN lesion had a positive BCR beginning early during voiding. The finding of suprasegmental modulation of the BCR during voiding demonstrated by external urethral sphincter EMG was a more sensitive although slightly less specific sign of UMN bladder dysfunction than detrusor sphincter dyssynergia; uninhibited bladder contractions were neither sensitive nor specific for UMN lesions.