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Erschienen in: Child's Nervous System 8/2017

24.03.2017 | Original Paper

Somatosensory evoked potentials as a screening tool for diagnosis of spinal pathologies in children with treatment refractory overactive bladder

verfasst von: David Terence Thomas, Sevim Yener, Aybegum Kalyoncu, Kayihan Uluc, Yasar Bayri, Adnan Dagcinar, Tolga Dagli, Halil Tugtepe

Erschienen in: Child's Nervous System | Ausgabe 8/2017

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Abstract

Purpose

To evaluate the usefulness of somatosensory evoked potential as a screening tool for spinal pathologies in patients with treatment refractory overactive bladder.

Methods

This prospective study was performed between January 2011 and January 2014. Children >5 years old with treatment refractory overactive bladder were enrolled after exclusion of anatomical and neurological causes of incontinence. All patients underwent urodynamic studies, spinal MRI, and somatosensory evoked potential (SEP). Sensitivity, specificity, PPV, and NPV were calculated for SEP.

Results

Thirty-one children (average age 8.3 ± 2.9 years) were included in the study. SEP was abnormal in 13 (41.9%), and MRI was abnormal in 8 (25.8%) patients. SEP was found to have a sensitivity of 87.5%, a specificity of 73.9%, positive predictive value of 53.85%, and negative predictive value (NPV) of 94.4%.

Conclusion

In patients with treatment refractory OAB, SEP is an important tool for the screening of tethered cord/spinal pathologies. Our results suggest that a child with a normal SEP study in this group of patients may not require further investigation with MRI.
Literatur
1.
Zurück zum Zitat Ayan S, Topsakal K, Gokce G, Gultekin EY (2007) Efficacy of combined anticholinergic treatment and behavioral modification as a first line treatment for nonneurogenic and nonanatomical voiding dysfunction in children: a randomized controlled trial. J Urol 177:2325–2328 discussion 2328–9CrossRefPubMed Ayan S, Topsakal K, Gokce G, Gultekin EY (2007) Efficacy of combined anticholinergic treatment and behavioral modification as a first line treatment for nonneurogenic and nonanatomical voiding dysfunction in children: a randomized controlled trial. J Urol 177:2325–2328 discussion 2328–9CrossRefPubMed
2.
Zurück zum Zitat Chase J, Austin P, Hoebeke P, McKenna P (2010) The management of dysfunctional voiding in children: a report from the Standardisation Committee of the International Children’s Continence Society. J Urol 183:1296–1302CrossRefPubMed Chase J, Austin P, Hoebeke P, McKenna P (2010) The management of dysfunctional voiding in children: a report from the Standardisation Committee of the International Children’s Continence Society. J Urol 183:1296–1302CrossRefPubMed
3.
Zurück zum Zitat Hoebeke P, Renson C, Petillon L et al (2002) Percutaneous electrical nerve stimulation in children with therapy resistant nonneuropathic bladder sphincter dysfunction: a pilot study. J Urol 168:2605–2607 discussion 2607–8CrossRefPubMed Hoebeke P, Renson C, Petillon L et al (2002) Percutaneous electrical nerve stimulation in children with therapy resistant nonneuropathic bladder sphincter dysfunction: a pilot study. J Urol 168:2605–2607 discussion 2607–8CrossRefPubMed
5.
Zurück zum Zitat Malm-Buatsi E, Nepple KG, Boyt MA et al (2007) Efficacy of transcutaneous electrical nerve stimulation in children with overactive bladder refractory to pharmacotherapy. Urology 70:980–983CrossRefPubMed Malm-Buatsi E, Nepple KG, Boyt MA et al (2007) Efficacy of transcutaneous electrical nerve stimulation in children with overactive bladder refractory to pharmacotherapy. Urology 70:980–983CrossRefPubMed
6.
Zurück zum Zitat Khen-Dunlop N, Van Egroo A, Bouteiller C et al (2006) Biofeedback therapy in the treatment of bladder overactivity, vesico-ureteral reflux and urinary tract infection. J Pediatr Urol 2:424–429CrossRefPubMed Khen-Dunlop N, Van Egroo A, Bouteiller C et al (2006) Biofeedback therapy in the treatment of bladder overactivity, vesico-ureteral reflux and urinary tract infection. J Pediatr Urol 2:424–429CrossRefPubMed
7.
Zurück zum Zitat Lordêlo P, Benevides I, Kerner EG et al (2010) Treatment of non-monosymptomatic nocturnal enuresis by transcutaneous parasacral electrical nerve stimulation. J Pediatr Urol 6:486–489CrossRefPubMed Lordêlo P, Benevides I, Kerner EG et al (2010) Treatment of non-monosymptomatic nocturnal enuresis by transcutaneous parasacral electrical nerve stimulation. J Pediatr Urol 6:486–489CrossRefPubMed
8.
Zurück zum Zitat Varlam DE, Dippell J (1995) Non-neurogenic bladder and chronic renal insufficiency in childhood. Pediatr Nephrol 9:1–5CrossRefPubMed Varlam DE, Dippell J (1995) Non-neurogenic bladder and chronic renal insufficiency in childhood. Pediatr Nephrol 9:1–5CrossRefPubMed
9.
Zurück zum Zitat Yamada S, Iacono RP, Andrade T et al (1995) Pathophysiology of tethered cord syndrome. Neurosurg Clin N Am 6:311–323PubMed Yamada S, Iacono RP, Andrade T et al (1995) Pathophysiology of tethered cord syndrome. Neurosurg Clin N Am 6:311–323PubMed
10.
Zurück zum Zitat Steinbok P, MacNeily AE (2007) Section of the terminal filum for occult tethered cord syndrome: toward a scientific answer. Neurosurg Focus 23:E5CrossRefPubMed Steinbok P, MacNeily AE (2007) Section of the terminal filum for occult tethered cord syndrome: toward a scientific answer. Neurosurg Focus 23:E5CrossRefPubMed
11.
Zurück zum Zitat Khoury AE, Hendrick EB, McLorie GA et al (1990) Occult spinal dysraphism: clinical and urodynamic outcome after division of the filum terminale. J Urol 144:426–428 discussion 428–9, 443–4CrossRefPubMed Khoury AE, Hendrick EB, McLorie GA et al (1990) Occult spinal dysraphism: clinical and urodynamic outcome after division of the filum terminale. J Urol 144:426–428 discussion 428–9, 443–4CrossRefPubMed
12.
Zurück zum Zitat Nazar GB, Casale AJ, Roberts JG, Linden RD (1995) Occult filum terminale syndrome. Pediatr Neurosurg 23:228–235CrossRefPubMed Nazar GB, Casale AJ, Roberts JG, Linden RD (1995) Occult filum terminale syndrome. Pediatr Neurosurg 23:228–235CrossRefPubMed
13.
Zurück zum Zitat Kraft GH, Aminoff MJ, Baran EM et al (1998) Somatosensory evoked potentials: clinical uses. Muscle Nerve 21:252–258CrossRefPubMed Kraft GH, Aminoff MJ, Baran EM et al (1998) Somatosensory evoked potentials: clinical uses. Muscle Nerve 21:252–258CrossRefPubMed
14.
Zurück zum Zitat Kiliçkesmez O, Barut Y, Taşdemiroğlu E (2003) MRI features of adult tethered cord syndrome. Tani Girisim Radyol 9:295–301PubMed Kiliçkesmez O, Barut Y, Taşdemiroğlu E (2003) MRI features of adult tethered cord syndrome. Tani Girisim Radyol 9:295–301PubMed
15.
Zurück zum Zitat McLone DG, La Marca F (1997) The tethered spinal cord: diagnosis, significance, and management. Semin Pediatr Neurol 4:192–208CrossRefPubMed McLone DG, La Marca F (1997) The tethered spinal cord: diagnosis, significance, and management. Semin Pediatr Neurol 4:192–208CrossRefPubMed
16.
Zurück zum Zitat Kale SS, Mahapatra AK (1998) The role of somatosensory evoked potentials in spinal dysraphism—do they have a prognostic significance? Childs Nerv Syst 14:328–331CrossRefPubMed Kale SS, Mahapatra AK (1998) The role of somatosensory evoked potentials in spinal dysraphism—do they have a prognostic significance? Childs Nerv Syst 14:328–331CrossRefPubMed
17.
Zurück zum Zitat Li V, Albright AL, Sclabassi R, Pang D (1996) The role of somatosensory evoked potentials in the evaluation of spinal cord retethering. Pediatr Neurosurg 24:126–133CrossRefPubMed Li V, Albright AL, Sclabassi R, Pang D (1996) The role of somatosensory evoked potentials in the evaluation of spinal cord retethering. Pediatr Neurosurg 24:126–133CrossRefPubMed
18.
Zurück zum Zitat Ko KF (2010) The role of evoked potential and MR imaging in assessing multiple sclerosis: a comparative study. Singap Med J 51:716–720 Ko KF (2010) The role of evoked potential and MR imaging in assessing multiple sclerosis: a comparative study. Singap Med J 51:716–720
19.
Zurück zum Zitat Haghighi SS, Mundis G, Zhang R, Ramirez B (2011) Correlation between transcranial motor and somatosensory-evoked potential findings in cervical myelopathy or radiculopathy during cervical spine surgery. Neurol Res 33:893–898CrossRefPubMed Haghighi SS, Mundis G, Zhang R, Ramirez B (2011) Correlation between transcranial motor and somatosensory-evoked potential findings in cervical myelopathy or radiculopathy during cervical spine surgery. Neurol Res 33:893–898CrossRefPubMed
Metadaten
Titel
Somatosensory evoked potentials as a screening tool for diagnosis of spinal pathologies in children with treatment refractory overactive bladder
verfasst von
David Terence Thomas
Sevim Yener
Aybegum Kalyoncu
Kayihan Uluc
Yasar Bayri
Adnan Dagcinar
Tolga Dagli
Halil Tugtepe
Publikationsdatum
24.03.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 8/2017
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-017-3393-2

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