Dynamic somatosensory evoked potential and magnetic resonance imaging in pudendal neuropathy: A comparative study with respect to the clinical diagnostic criteria

Aim: Pudendal neuropathy (PN) is a common cause of chronic perineal pain and usually diagnosed long after the onset of symptoms. Diagnostic work-up of PN mainly includes radiologic and neurophysiological studies. However, there is no established diagnostic test to confirm the clinical diagnosis. Thi...

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Main Authors: Burcu Ormeci, Handan Uzunçakmak Uyanık, Neslihan Taşdelen, Elif Çiğdem Keleş, Tibet Erdoğru, Ali Emre Öge
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-01-01
Series:Neurological Sciences and Neurophysiology
Subjects:
Online Access:http://www.nsnjournal.org/article.asp?issn=2636-865X;year=2022;volume=39;issue=3;spage=119;epage=125;aulast=Ormeci
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author Burcu Ormeci
Handan Uzunçakmak Uyanık
Neslihan Taşdelen
Elif Çiğdem Keleş
Tibet Erdoğru
Ali Emre Öge
author_facet Burcu Ormeci
Handan Uzunçakmak Uyanık
Neslihan Taşdelen
Elif Çiğdem Keleş
Tibet Erdoğru
Ali Emre Öge
author_sort Burcu Ormeci
collection DOAJ
description Aim: Pudendal neuropathy (PN) is a common cause of chronic perineal pain and usually diagnosed long after the onset of symptoms. Diagnostic work-up of PN mainly includes radiologic and neurophysiological studies. However, there is no established diagnostic test to confirm the clinical diagnosis. This study aims to evaluate the correlation between the dynamic pudendal somatosensory evoked potential (SEP) and pudendal magnetic resonance imaging (MRI) in patients with PN diagnosed clinically based on Nantes criteria as the gold standard for comparison. Methods: Forty-three patients (25 females, 18 males) were included in the study. Dynamic pudendal SEP as a novel method, which includes both provocative positioning and stimulation of each side separately, and pudendal MRI were performed in each patient. Results: Dynamic pudendal SEPs were found to be abnormal in 42, normal in 12 of the 54 clinically symptomatic nerves and abnormal in 2, normal in 30 of the 32 clinically asymptomatic nerves. Pudendal MRI was abnormal in 19, normal in 35 of the 54 clinically symptomatic nerves and abnormal in 8 and normal in 24 of the 32 clinically asymptomatic nerves. There was 84% agreement between clinical diagnosis and dynamic pudendal SEP (high sensitivity and specificity), 49% agreement between clinical diagnosis and pudendal MRI (low sensitivity and acceptable specificity), 53% agreement between dynamic pudendal SEP and pudendal MRI. Conclusions: The novel dynamic pudendal SEP method seems to be useful in supporting the clinical diagnosis of PN, while pudendal MRI lacks sufficient sensitivity to be used alone in diagnosis of PN.
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spelling doaj.art-c255e64a94034808832fc975739744222022-12-22T04:30:20ZengWolters Kluwer Medknow PublicationsNeurological Sciences and Neurophysiology2636-865X2022-01-0139311912510.4103/nsn.nsn_239_21Dynamic somatosensory evoked potential and magnetic resonance imaging in pudendal neuropathy: A comparative study with respect to the clinical diagnostic criteriaBurcu OrmeciHandan Uzunçakmak UyanıkNeslihan TaşdelenElif Çiğdem KeleşTibet ErdoğruAli Emre ÖgeAim: Pudendal neuropathy (PN) is a common cause of chronic perineal pain and usually diagnosed long after the onset of symptoms. Diagnostic work-up of PN mainly includes radiologic and neurophysiological studies. However, there is no established diagnostic test to confirm the clinical diagnosis. This study aims to evaluate the correlation between the dynamic pudendal somatosensory evoked potential (SEP) and pudendal magnetic resonance imaging (MRI) in patients with PN diagnosed clinically based on Nantes criteria as the gold standard for comparison. Methods: Forty-three patients (25 females, 18 males) were included in the study. Dynamic pudendal SEP as a novel method, which includes both provocative positioning and stimulation of each side separately, and pudendal MRI were performed in each patient. Results: Dynamic pudendal SEPs were found to be abnormal in 42, normal in 12 of the 54 clinically symptomatic nerves and abnormal in 2, normal in 30 of the 32 clinically asymptomatic nerves. Pudendal MRI was abnormal in 19, normal in 35 of the 54 clinically symptomatic nerves and abnormal in 8 and normal in 24 of the 32 clinically asymptomatic nerves. There was 84% agreement between clinical diagnosis and dynamic pudendal SEP (high sensitivity and specificity), 49% agreement between clinical diagnosis and pudendal MRI (low sensitivity and acceptable specificity), 53% agreement between dynamic pudendal SEP and pudendal MRI. Conclusions: The novel dynamic pudendal SEP method seems to be useful in supporting the clinical diagnosis of PN, while pudendal MRI lacks sufficient sensitivity to be used alone in diagnosis of PN.http://www.nsnjournal.org/article.asp?issn=2636-865X;year=2022;volume=39;issue=3;spage=119;epage=125;aulast=Ormecidynamic somatosensory evoked potentialmagnetic resonance imagingneurographypudendal neuropathy
spellingShingle Burcu Ormeci
Handan Uzunçakmak Uyanık
Neslihan Taşdelen
Elif Çiğdem Keleş
Tibet Erdoğru
Ali Emre Öge
Dynamic somatosensory evoked potential and magnetic resonance imaging in pudendal neuropathy: A comparative study with respect to the clinical diagnostic criteria
Neurological Sciences and Neurophysiology
dynamic somatosensory evoked potential
magnetic resonance imaging
neurography
pudendal neuropathy
title Dynamic somatosensory evoked potential and magnetic resonance imaging in pudendal neuropathy: A comparative study with respect to the clinical diagnostic criteria
title_full Dynamic somatosensory evoked potential and magnetic resonance imaging in pudendal neuropathy: A comparative study with respect to the clinical diagnostic criteria
title_fullStr Dynamic somatosensory evoked potential and magnetic resonance imaging in pudendal neuropathy: A comparative study with respect to the clinical diagnostic criteria
title_full_unstemmed Dynamic somatosensory evoked potential and magnetic resonance imaging in pudendal neuropathy: A comparative study with respect to the clinical diagnostic criteria
title_short Dynamic somatosensory evoked potential and magnetic resonance imaging in pudendal neuropathy: A comparative study with respect to the clinical diagnostic criteria
title_sort dynamic somatosensory evoked potential and magnetic resonance imaging in pudendal neuropathy a comparative study with respect to the clinical diagnostic criteria
topic dynamic somatosensory evoked potential
magnetic resonance imaging
neurography
pudendal neuropathy
url http://www.nsnjournal.org/article.asp?issn=2636-865X;year=2022;volume=39;issue=3;spage=119;epage=125;aulast=Ormeci
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