Clinical and Electrophysiological Findings in Patients with Spinal Cord Injury

Scientific background: Neurological examination can provide preliminary informations about the patients and prognosis but it is usually unsatisfactory. Neurophysiological investigations can provide more detailed information about the prognosis of the disease, such as; determining the severity of the lesion and detecting pathological changes that may be underestimated during the clinical evaluations. Objective: The aim of this study is to compare the clinical and the electrophysiological findings in patients with spinal cord injury. Material and methods: In 31 patients with spinal cord injury, we evaluated motor and peripheral nerve conduction velocities, paraspinal, anal sphincter, and extremity electromyographies (EMG); median and posterior tibial nerve somatosensorial responses (SEP); symphathetic clinical responses. Clinical and electrophysiological results were compared with statistical analysis. Results: There was no correlation between the disease duration and spasm frequency in lower extremities, but a significant correlation was found between the spasm frequency and spasticity severity in cases whom H reflexes could be obtained (p<0.05). H-RIM responses were increasing with the severity of spasticity. The electrophysiological findings revealed lower (25.8%) and upper (48.4%) extremity entrapment neuropathies in cases. There was a negative correlation between the deep tendon reflexes, increased tonus and SA severity (p<0.001). The patients with SA had significantly short disease duration (p<0.05). Severity of spasticity (p=0.001) and the frequency of spasms (p=0.04) were increasing with the decreasing severity of SA in anal sphincter. Besides this, we observed that, the more widely dispersed denervation in the paraspinal muscles, the less the level of lower extremity spasticity (p=0.001) and the frequency of the spasms (p=0.07). Symphathetic skin responses were disappeared with an average of two dermatomes below the sensorial level. Only one patient had an electrophysiological partial denervation though his neurological examination showed total spinal involvement.Conclusion: Electrophysiological investigations can yield significant information about the clinical findings and the prognosis of the disease.