Surgery Today

, Volume 27, Issue 7, pp 632–637 | Cite as

Abnormalities in visceral evoked potentials from the anal canal in children with chronic constipation

  • Masayuki Kubota
  • Sachiyo Suita
  • Tetsuro Kamimura
Original Articles

Abstract

The integrity of the sensory nervous system in the anal canals of chronically constipated children was investigated using evoked potential techniques examining cerebral and spinal evoked potentials from the lower extremities and anal canal. Stimulation of the posterior tibial nerve produced no significant difference in the parameters of spinal and cerebral evoked potentials between 18 controls and 12 chronically constipated chidren. However, stimulation of the anal canal resulted in evoked potentials related to the age and/or consciousness level of the control children. Reproducible cerebral responses were obtained only from nine of these control children, all aged over 4 years, who were examined while awake without sedatives. A typical response was characterized by a polyphasic wave occurring with an onset latency of 79.4± 27.7ms (mean ±SD). In the 12 chronically constipated children, the 5 sedated patients examined while asleep did not show any reproducible potential, as in the controls. However, in the remaining 7 children examined while awake, the occurrence of the anal canal evoked potential was significantly reduced, and only two exhibited a cerebral response. These findings suggest that rectal mucosal perception of the intraluminal stimuli might be disturbed in some children with chronic constipation.

Key Words

evoked potential anal canal chronic constipation child 

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References

  1. 1.
    Frieling T, Enck P, Wienbeck M (1989) Cerebral responses evoked by electrical stimulation of the esophagus in normal subjects. Gastroenterology 97:475–478PubMedGoogle Scholar
  2. 2.
    Castell DO, Wood JD, Frieling T, Wright FS, Vieth RF (1990) Cerebral electrical potentials evoked by balloon distension of the human esophagus. Gastroenterology 98:662–666PubMedGoogle Scholar
  3. 3.
    Smout AJPM, DeVore MS, Castell DO (1990) Cerebral potentials evoked by esophageal distention in humans. Am J Physiol 259:G955-G959PubMedGoogle Scholar
  4. 4.
    Meunier P, Collet L, Duclaux R, Chéry-Crozé S (1987) Endorectal cerebral evoked potentials in human. Int J Neuroscience 37:193–196Google Scholar
  5. 5.
    Collet L, Meunier P, Duclaux R, Chéry-Crozé S, Falipou P (1988) Cerebral evoked potentials after endorectal mechanical stimulation in humans. Am J Physiol 254:G477-G482PubMedGoogle Scholar
  6. 6.
    Freilling T, Enck P, Wienbeck M (1989) Cerebral responses evoked by electrical stimulation of rectosigmoid in normal subjects. Dig Dis Sci 34:202–205Google Scholar
  7. 7.
    Loening-Baucke V, Read NW, Yamada T (1991) Cerebral evoked potentials after rectal stimulation. Electroenceph Clin Neurophysiol 80:490–495PubMedGoogle Scholar
  8. 8.
    Loening_Baucke V, Read NW, Yamada T (1992) Further evaluation of the afferent nervous pathways from the rectum. Am J Physiol 262:G927-G933PubMedGoogle Scholar
  9. 9.
    Loening-Baucke V, Yamada T (1993) Cerebral potentials evoked by rectal distention in humans. Electroenceph Clin Neurophysiol 88:447–452PubMedGoogle Scholar
  10. 10.
    Speakman CTM, Kamm MA, Swash M (1993) Rectal sensory evoked potentials: an assessment of their clinical value. Int J Colorect Dis 8:23–28Google Scholar
  11. 11.
    Delèchenault P, Leroi AM, Bruna T, Denis P, Weber J (1993) Cerebral potentials evoked by electrical stimulation of the anal canal. Dis Colon Rectum 36:55–60PubMedGoogle Scholar
  12. 12.
    Tsumoto T, Hirose N, Nonaka S, Takahashi M (1972) Analysis of somatosensory evoked potentials to lateral popliteal stimulation in man. Electroenceph Clin Neurophysiol 33:379–388CrossRefPubMedGoogle Scholar
  13. 13.
    George SR, Taylor MJ (1991) Somatosensory evoked potentials in neonates and infants: development and normative data. Electroenceph Clin Neurophysiol 80:94–102PubMedGoogle Scholar
  14. 14.
    Kubota M, Nagasaki A, Sumitomo K (1992) Manometric evaluation of children with chronic constipation using a suctionstimulating electrode. Eur J Pediatr Surg 2:287–290PubMedGoogle Scholar
  15. 15.
    Duthie HL, Gairns FW (1960) Sensory nerve-endings and sensation in the anal region of man. Br J Surg 206:585–595Google Scholar
  16. 16.
    Gould RP (1960) Sensory innervation of the anal canal. Nature 187:337–338Google Scholar
  17. 17.
    Gänzer H, Madersbacher H, Rumpl E (1991) Cortical evoked potentials by stimulation of the vesicoureteral junction: Clinical value and neurophysiological considerations. J Urol 146:118–123PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • Masayuki Kubota
    • 1
  • Sachiyo Suita
    • 1
  • Tetsuro Kamimura
    • 1
  1. 1.Department of Pediatric Surgery, Faculty of MedicineKyushu UniversityFukuokaJapan

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