An upper motor neurone lesion will usually comprise which of the following features?A. A lesion at T10 or above with an atonic bladder
In spinal cord injuries at or above the level of T10, the patient is most likely to have an upper motor neurone type injury with neurogenic detrusor overactivity and detrusor-sphincterdyssynergia (DSD). DSD is defined as involuntary contraction of the urethral and/or periurethral striated muscle simultaneously with a detrusor contraction. This is the result of loss of co-ordination by the pontine micturition centre. The typical appearance on a pressure-flow trace is drawn as shown in figure below.
Pressure/flow trace and EMG in a spinal cord injured patient with DSD. (From Hussain, M. et al., BJMSU, 5, 192–203, 2012.)