/Testing for Pudendal Neuropathy

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Doctor

Conway does only the EMG testing. A friend of mine flew down to West Virginia

to have the PNMLT done, as there was no one in the Boston/Rhode Island area

that did either test. It was shortly after she had her test done that Dr.

Conway completed his training in France along with his technician who does the

testing. She went to France with him also. The machine that she uses is made in

France and when she started doing the testing, it was the only one in the US.

There may be more now. I will ask my friend if she knows what the difference is

between the two tests is. But if you read the description carefully below, the

PNMLT test does not test the entire body. The EMG tests the entire

length of the pudendal nerve. I know I had electrodes in my forehead and they shocked

other areas of my body to look for nerve conductuity in the spine, to make sure

there are no issues with spinal conductivity. They don’t do that with the

PNMLT testing.

nne

From:

VulvarDisorders [mailto:VulvarDisorders ] On

Behalf Of euc1109 s

Sent: Saturday, February 09, 2008 9:59 AM

To: VulvarDisorders

Subject: Re: Testing for Pudendal Neuropathy

i don't really understand the difference

between this

and the emg. does dr. conway do this? i had the emg

done by him but it sounds the same....

erin

--- millburytimes

wrote:

> Below is a description of testing done for a

> possible compression of the pudendal nerve.

>

>

>

> A PNMLT is an electrophysiological procedure,

> similar to an EMG (electromyogram), which measures

> the speed of nerve conduction. This exam is done by

> a neurologist. Not all neurologists have the

> necessary equipment to do this type of examination.

> During this exam, the pudendal nerve is stimulated

> electrically inside the rectum (or vagina) at the

> ischial spine with electrodes on the tip of a

> special glove. The speed of the nerve conduction is

> recorded by a small needle inserted in the perineum.

> If the nerve responds slower than normal, this gives

> an indication that the nerve may be entrapped or

> damaged.

>

>

>

> The PNMLT examines only the motor function of the

> nerve. There is no way to test for the sensory

> fibers of the nerve which transmit pain. The reason

> for the test is based on the assertion that an

> abnormal motor function will most likely conceal a

> sensory affection as well. So, an abnormal PNMLT

> indicates that the pudendal nerve is affected but a

> normal reading does not rule out PNE. In this case

> an entrapment could exist even if the motor fiber of

> the nerve has not been affected yet. This is more

> common with people who have had PNE only for a short

> period of time. Nevertheless, the PNMLT is the most

> accurate neurological examination for the pudendal

> nerve.

>

>

>

> The neurological examination can be completed by the

> measurement of the anal reflex latency, measurements

> of the bulbocavernosus reflex latencies (BCRLs),

> somatosensory evoked potentials of the pudendal

> nerve (SEPPNs) and the sensory conduction velocity

> of the dorsal nerve of the penis (SCVDNP). Those

> exams can give further information about the

> condition of the nerve or the origin of the pain.

>

>

>

> The EMG tests the entire length of the pudendal

> nerve. I had electrodes in my forehead and they

> shocked other areas of my body to look for nerve

> conductuity in the spine, to make sure there are no

> issues with spinal conductivity.

>

>

>

> My understanding, (reports I have heard from other

> doctors), is that the PNMLT is more reliable than

> the EMG. Every doctor though has their own opinion

> and the PNMLT is sometimes not a great indicator of

> entrapment or not.

>

>

>

> nne

>

>

>

>

>

>

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