Electrodiagnostic tests may be valuable in the assessment
of patients with anorectal dysfunction and are complementary to
imaging and manometry. While the latter delineate morphological
and functional sphincter changes, respectively,
electrodiagnostic methods document, help to localize and assess
the severity and mechanism of neural injury. These data are
important for the treatment of patients and for estimating their
prognoses. Among electrodiagnostic tests, concentric needle
electromyography of the external anal sphincter is the most
important. It demonstrates muscle denervation, quantitatively
estimates muscle reinnervation, estimates the level of motor
neuron excitability and assesses several kinesiological
parameters. In addition, measurement of the bulbocavernosus
reflex is often useful, while pudendal somatosensory evoked
potentials are sometimes useful. Use of single tests of sacral
nervous system by workers less familiar with theoretical
principles of clinical neurophysiology is discouraged. In
patients with suspected neurogenic bowel disorders,
comprehensive electrodiagnostic approach, performed by clinical
neurophysiologists experienced in application of these tests to
the sacral nervous system, should complement data obtained by
other methods and giude patient management.
Key words
Anal incontinence - Constipation - Electrodiagnosis - External anal sphincter - Needle electromyography - Pelvic floor
Presented in part at the Meeting of the
Mediterranean Society of Coloproctology, Oto
ec, Slovenia,
September 2002.