Anal reflex versus bulbocavernosus reflex in evaluation of patients with spinal cord injury

Model System:

SCI

Reference Type:

Journal article

Accession No.:

J85942

Journal:

Spinal Cord Series and Cases

Year, Volume, Issue, Page(s):

2020 , 6, 2,

Publication Website:

Abstract:

Article describes two sacral reflexes used in the clinical evaluation of patients with spinal cord injury (SCI). The examination of sacral reflexes provides an important method to differentiate an upper motor neuron versus lower motor neuron SCI. Two common sacral mediated reflexes used as part of the neurological assessment include the bulbocavernosus reflex (BCR) and anal reflex. Gently squeezing the clitoris, tapping and squeezing the clitoris, gentle tapping of the clitoris, and gently touching the labium minus lateral to the clitoris’ resulting in anal sphincter contraction, have been described as methods for eliciting the BCR in women. In men, the BCR is usually performed with the squeezing of the glans penis and observing anal sphincter contraction or palpating the bulbocavernosus muscle contraction. The anal reflex is usually elicited with pinprick stimulation at the mucocutaneous junction of the anus and observing for anal sphincter contraction. As the clinical information from these tests are similar, the authors suggest that the anal reflex as opposed to the BCR be considered as the primary sacral reflex test in clinical practice. The anal reflex is less intrusive and is already being performed as part of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) by pinprick stimulation of the S4–5 dermatome.

Author(s):

Kirshblum, Steven |Eren, Fatma|