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Thursday, May 14, 2009

Bulbocavernosus reflex

The bulbocavernosus reflex is a polysynaptic reflex that is useful in testing for spinal shock and gaining information about the state of spinal cord injuries (SCI). The test involves monitoring anal sphincter contraction in response to squeezing the glans penis or tugging on an indwelling Foley catheter. The reflex is spinal mediated and involves S1-S3. The absence of the reflex without sacral spinal cord trauma indicates spinal shock. Typically this is one of the first reflexes to return after spinal shock. Lack of motor and sensory function after the reflex has returned indicates complete SCI. Absence of this reflex in instances where spinal shock is not suspected could indicate a lesion or injury of the conus medullaris or sacral nerve roots.

This reflex can also be tested electrophysiologically, by stimulating the penis or vulva and recording from the anal sphincter. This test modality is used in intraoperative neurophysiology monitoring to verify function of sensory and motor sacral roots as well as the conus medullaris.

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