[Deep pudendal reflex]. / Reflejo pudendo profundo.

32 healthy women ranging from 20 to 68 years (51.84 +/- 10.36) were tested for Deep Pudendal Reflex (DPR). Dantec 13L40 (St. Mark's) superficial electrodes were used to pick up the responses of the external anal sphincter. These devices consist of a bipolar stimulating electrode mounted on the tip of the gloved index finger which is inserted into the rectum; 3 cm proximally at the base of the finger are recording electrodes which pick up the contraction response of the anal sphincter. To obtain the DPR the ischial spine is localized on transrectal examination and electrical stimuli given at that side, applying square stimulus of 0.2 ms duration and 0.5 Hz frequency. This stimulates the pudendal nerve as it leaves the pelvis through the greater sciatic notch, before it branches into the inferior rectal (to the anal sphincter) and perineal nerve (to the periurethral striated muscle). The conduction time was measured as the latency from the time of stimulation of the starting point of the reflex response curves. The shortest latency of various responses was accepted and measured in milliseconds (ms). The amplitudes of the responses were measured in microvolts (uv). We obtained reproducible DPR in all subjects. Mean latency was 36.18 +/- 4.29 ms; mean amplitude was 337.50 +/- 218.49 uv (Fig. 1, Table 2). DPR is a pudendal-anal reflex like the bulbo-cavernous reflex, but differs in latency, stimulation localization and afferent limb although both follow a common final afferent pathway.

Pudendal reflexes in women with pelvic floor disorders.

The objective of this work was to study two pudendal anal reflexes: Deep Pudendal Reflex (DPR) and classical Bulbocavernosus Reflex (BCR) in women with primary and recurrent genital prolapse to obtain support to the hypothesis of pelvic nerve damage in patients with pelvic floor disorders. 124 women were studied: 68 were normal; 38 with genital prolapse (GP); and 18 with recurrent GP. Clinical and electrophysiological studies were carried out. Delayed reflex responses were found in 44/56 of patients (79%). [27/38 in genital prolapse group (71%); 17/18 in recurrent GP group (94%)]. The evaluation of pelvic floor reflex responses are tests to be taken into account in the diagnosis and management of pelvic floor disorders.

Disfunción urinaria en el síndrome de Isaacs / Urinary dysfunctiion of acquired neuromyotonia (Isaacs'Syndrome)

La neuromiotonía es una afección que se presenta con endurecimiento muscular difuso, espasmos y/o acalmbres, usualmente asociados a hiperhidrosis, que pueden observarse en forma idiopática o secundaria. En 1961, Isaacs describió el síndrome en forma completa demostrando su origen en los nervios periféricos. Puede corresponder a patología hereditaria o adquirida, asociándopse a cuadros pareneoplásicos o autoinmunes, con o sin neuropatía periférica. Existe una sola coimunicación en la literatura de Síndrome de Isaacs con disfunción urinaria. Nosotros presentamos la primera descripción urodinámica realizada a una paciente con dicha entidad comprobando la presencia de una hiperreflexia rectal y del detrusor, hallazgos generalmente asociados a lesiones del SNC

Síndrome Post-polio / Clinical features and electromyographic variables in patients with post-polio syndrome

La primera descripción del síndrome de post-polio fue publicada en la literatura francesa en 1875, pero se reconoce recién esta entidad a partir de la dúcada de los 80. Su inicio es aproximadamente 30 años después del episodio agudo a través de distintos síntomas: fatiga, debilidad de músculos previamente afectados y previamente no afectados, dolor, intolerancia al frío, atrofia muscular y nuevos problemas de la vida diaria. Se estudiaron 12 pacientes que presentaron nueva sintomatología, principalmente debilidad muscular y dolor en distintos grupos musculares, ya sea por desuso o por un esfuerzo exagerado y dolor en las articulaciones