Structural abnormalities of the pelvic floor or viscera
EMG of external anal sphincter Diagnosis
Bulbocavernosus reflex Pudendal SEP
Anorectal manometry, urodynamic examinations Imaging
Amarenco G, Ismael SS, Bayle B, et al (2001) Electrophysiological analysis of pudendal References neuropathy following traction. Muscle Nerve 24: 11 6-11 9
Podnar S, Vodusek DB (2001) Standardization of anal sphincter electromyography: utilty of motor unit potential parameters. Muscle Nerve 24: 946-951
Mononeuropathies: lower extremities
The obturator nerve fibers stem from L2-4, and course within the belly of the Anatomy psoas muscle, emerging on the medial side of the psoas, then passing over the sacroiliac joint, and continuing along the wall of pelvis to the obturator canal.
Sensory loss, paresthesias, or radiating pain in the medial thigh. Disability in Symptoms walking due to impaired stabilization of the hip joint. The leg is held in an abducted position, leading to a wide-based gait. The adductor tendon reflex may be absent.
Neuralgic pain may be confused with osteitis. Signs Adductor weakness, with or without sensory deficits.
Trauma: pelvic fracture, gunshot, retroperitoneal hematoma
Obturator nerve injury occurs commonly with a femoral nerve lesion. Causes include retroperitoneal hematoma, cancer, hip arthroplasty, lymphoma.
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