Réponses évoquées électriques et mécaniques du sphincter anal externe après stimulations magnétiques corticales et lombaires

Abstract

In 13 healthy volunteers we recorded electrical and mechanical anal sphincter (AS) evoked responses. Electrical responses were obtained with surface electrodes, and mechanical responses by anal manometry; all responses were compared with those of anterior tibialis. Mechanical evoked responses’ latency and amplitude were calculated. The mean total conduction time of the electrical responses was 26.07 ms at rest and 23.31 ms with mild contraction ( p < 0.003). After lumbar magnetic stimulations, because of stimulation artefact, electrical responses couldn’t be correctly measured. The mean central conduction time calculated with mechanical responses was 21,44 ms at rest and 18,81 ms with mild contraction ( p < 0.003). The mean central conduction time to the anterior tibialis was shorter (14,38 ms ; p < 0.003). Evoked mechanical responses’, amplitudes were respectively 128,2 cm H 2O (cortical stimulations at rest), 138,8 cm H 2O (cortical stimulations with mild contraction) and 133,1 cm H 2O (lumbar stimulations at rest) (NS). Evoked mechanical responses amplitudes were correlated with the AS maximal voluntary contraction amplitude ( p < 10 –4). Mechanical motor evoked responses after cortical and lumbar magnetic stimulations can be recorded and quantified. In anorectal disorders, this technique could be of major interest for the diagnosis of neurologic lesions versus behavioural problems.