What is the place of electroneuromyographic studies in the diagnosis and management of pudendal neuralgia related to entrapment syndrome?
| Autor: | Jean-Jacques Labat, P. M. Boohs, S. Sheikh Ismael, M. Lefort, M. C. Arne-Bes, D. Prat-Pradal, B. Aranda, M. C. Scheiber-Nogueira, Jean-Yves Salle, Jean Pascal Lefaucheur, J M Soler, J-G Prévinaire, J. Benaim, Jacques Kerdraon, G. Amarenco, J. P. Galaup, R. J. Opsomer, Kathleen Charvier, V. Bonniaud, P. Dumas, Philippe Lacroix, Bernard Parratte, Anne-Marie Leroi, D. Lagauche, E. Lapeyre, A. G. Herbaut, Christian Thomas, Patrick Raibaut, M. F. Testut, F. Daemgen |
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| Přispěvatelé: | Neuroépidémiologie Tropicale et Comparée (NETEC), Université de Limoges (UNILIM)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503), Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Service de Médecine Physique et de Réadaptation [CHU Limoges] |
| Jazyk: | angličtina |
| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
Pudendal nerve MESH: Neuralgia 030232 urology & nephrology Context (language use) Electromyography Neurological disorder MESH: Electromyography 03 medical and health sciences 0302 clinical medicine Physiology (medical) medicine Humans Peripheral Nerves MESH: Humans medicine.diagnostic_test business.industry Electrodiagnosis Nerve Compression Syndromes Pudendal neuralgia MESH: Electric Stimulation General Medicine MESH: Electrodiagnosis medicine.disease MESH: Peripheral Nerves Electric Stimulation 3. Good health Surgery medicine.anatomical_structure Neurology Anesthesia Reflex Neuralgia MESH: Nerve Compression Syndromes [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie Neurology (clinical) business 030217 neurology & neurosurgery Sensory nerve |
| Zdroj: | Neurophysiologie Clinique/Clinical Neurophysiology Neurophysiologie Clinique/Clinical Neurophysiology, Elsevier Masson, 2007, 37 (4), pp.223-8. ⟨10.1016/j.neucli.2007.07.004⟩ |
| ISSN: | 0987-7053 |
| Popis: | International audience; Entrapment of the pudendal nerve may be at the origin of chronic perineal pain. This syndrome must be diagnosed because this can result in the indication of surgical decompression of the entrapped nerve for pain relief. Electroneuromyographic (ENMG) investigation is often performed in this context, based on needle electromyography and the study of sacral reflex and pudendal nerve motor latencies. The limits of ENMG investigation, owing to various pathophysiological and technical considerations, should be known. The employed techniques do not assess directly the pathophysiological mechanisms of pain but rather correlate to structural alterations of the pudendal nerve (demyelination or axonal loss). In addition, only direct or reflex motor innervation is investigated, whereas sensory nerve conduction studies should be more sensitive to detect nerve compression. Finally, ENMG cannot differentiate entrapment from other causes of pudendal nerve lesion (stretch induced by surgical procedures, obstetrical damage, chronic constipation...). Thus, perineal ENMG has a limited sensitivity and specificity in the diagnosis of pudendal nerve entrapment syndrome and does not give direct information about pain mechanisms. Pudendal neuralgia related to nerve entrapment is mainly suspected on specific clinical features and perineal ENMG examination provides additional, but no definitive clues, for the diagnosis or the localization of the site of compression. In fact, the main value of ENMG is to assess objectively pudendal motor innervation when a surgical decompression is considered. Perineal ENMG might predict the outcome of surgery but is of no value for intraoperative monitoring. |
| Databáze: | OpenAIRE |
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