Abstract
Patients with spinal cord injury show upper motor neuron dysfunction below the level of the lesion. Some patients with cervical and high thoracic injuries show unexpected lower leg atrophy and ankle jerk abnormalities together with persistence of urinary retention. Clinical, neurophysiological and urodynamic findings in 130 patients with cervical and thoracic injuries showed that 18 patients had additional lumbosacral dysfunction. Three patients had radiological findings demonstrating a second lesion of the lower spine. The remaining 15 patients, however, did not have any obvious bony lesion to account for the lumbosacral dysfunction. Atypical neurological findings, abnormal neurophysiological testing and aberrant detrusor behaviour were the essence of the occult lumbosacral dysfunction in cervical and thoracic spinal cord injury patients. Recognition of the presence of a double lesion was important for care of the neuropathic bladder and pain in addition to understanding the unexpected clinical signs.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Dimitrijevic M. R., Larsson L. E., Lehmkuhl D., Sherwood A. Evoked spinal cord and nerve root potentials in humans using a non-invasive recording technique. Electroencephalogr Clin Neurophysiol. 1978 Sep;45(3):331–340. doi: 10.1016/0013-4694(78)90185-2. [DOI] [PubMed] [Google Scholar]
- Dimitrijevic M. R., Prevec T. S., Sherwood A. M. Somatosensory perception and cortical evoked potentials in established paraplegia. J Neurol Sci. 1983 Aug;60(2):253–265. doi: 10.1016/0022-510x(83)90067-9. [DOI] [PubMed] [Google Scholar]
- Dimitrijević M. R., Nathan P. W. Studies of spasticity in man. 6. Habituation, dishabituation and sensitization of tenson reflexes in spinal man. Brain. 1973 Jun;96(2):337–354. doi: 10.1093/brain/96.2.337. [DOI] [PubMed] [Google Scholar]
- Dimitrijević M. R., Nathan P. W. Studies of spasticity in man. I. Some features of spasticity. Brain. 1967 Mar;90(1):1–30. doi: 10.1093/brain/90.1.1. [DOI] [PubMed] [Google Scholar]
- Ertekin C., Mutlu R., Sarica Y., Uçkardeşler L. Electrophysiological evaluation of the afferent spinal roots and nerves in patients with conus medullaris and cauda equina lesions. J Neurol Sci. 1980 Dec;48(3):419–433. doi: 10.1016/0022-510x(80)90113-6. [DOI] [PubMed] [Google Scholar]
- Gomori J. M., Grossman R. I., Bilaniuk L. T., Zimmerman R. A., Goldberg H. I. High-field MR imaging of superficial siderosis of the central nervous system. J Comput Assist Tomogr. 1985 Sep-Oct;9(5):972–975. doi: 10.1097/00004728-198509000-00029. [DOI] [PubMed] [Google Scholar]
- Lehmkuhl D., Dimitrijevic M. R., Renouf F. Electrophysiological characteristics of lumbosacral evoked potentials in patients with established spinal cord injury. Electroencephalogr Clin Neurophysiol. 1984 Apr;59(2):142–155. doi: 10.1016/0168-5597(84)90030-3. [DOI] [PubMed] [Google Scholar]
- Light J. K., Faganel J., Beric A. Detrusor areflexia in suprasacral spinal cord injuries. J Urol. 1985 Aug;134(2):295–297. doi: 10.1016/s0022-5347(17)47131-x. [DOI] [PubMed] [Google Scholar]
- Ragnarsson T. S., Durward Q. J., Nordgren R. E. Spinal cord tethering after traumatic paraplegia with late neurological deterioration. J Neurosurg. 1986 Mar;64(3):397–401. doi: 10.3171/jns.1986.64.3.0397. [DOI] [PubMed] [Google Scholar]