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The Pudendal Nerve Motor Latency Test
(PNMLT)

Note - This page has very old information and needs an update. The present version is May 14, 2002 .

Andrea provided this note from Diane:

"An above normal reading on the PNLT means that the pudendal nerve is damaged, but it does not indicate that the nerve is trapped, or that decompression surgery will help. The nerve could be damaged for other reasons. But nerve entrapment does not always result in an above normal reading on the PNLT - a person with a trapped pudendal nerve could have a normal reading on the PNLT. The nerve has to be very badly damaged to give an above-normal value on this test."

The following email on May 1, 2002 from greg_thibeaux on the Yahoo Pudendal Neuropathy forum explains quite a bit about the PNLT:

"Over here, in America, the doctors are not at all knowledgeable about PN. Therefore, it takes a person with this condition a long time to finally get an accurate diagnoses. By the time many of them realize they have PN, their nerve is in such bad condition that the shots do not make a dent into their pain. Their shots do not help at all and although they might have PN, they become discouraged about their plight. If they do not then have the test, they might very well choose not to have the surgery because there has been no positive indication (other than their symptoms) that they have PN. However, if they do have the test and it is abnormally high, then they will be more convinced that they have PN and will most probably go through with the surgery. "

In France, and perhaps England, the doctors are much more aware of PN, and I'm sure they make much quicker diagnoses than in America. Most probably, a diagnostic shot given after a person has had the condition for, say, 3-6 months is much more likely to reduce the pain, thereby either curing the patient, or at least diagnosing the patient's condition. The french doctors (Robert and Bensignor) maintain that many people get cured from the injections alone, and I believe them. However, in America, we don't know of anyone ever getting better from the shots, and the doctors that we go to have been instructed by the french regarding how to administer the shots. Why do you think this is so? I believe it is because by the time our patients realize that they could have PN, their nerves are in such poor condition that the injections do not help.

"Additionally, it is good for the American's to get the test (with an unclear result from the injections) because it is a much greater effort for them to fly all the way to France than say someone in England, France, or Germany for that matter. I do believe that Dr. Robert treats people a little bit differently if they are from far away than he does people who live in Europe. He doesn't want for persons living in America to travel to France if they don't have PN.

"To summarize, I do NOT think that the distal motor latency test, by itself, is AS important as the injections. However, given inconclusive results on a patient's injections, I do believe that this test becomes more important. While I do not claim to know how many or what percentage of Dr. Robert's patients have had the distal motor latency test, I do know that every American who has gone to Nantes has had the test. There must be a reason for it, you'd have to believe. Dr. Robert will not be able to handle everyone from the U.S. who wants this surgery. At some point (and I believe he's already at that point) he's got to develop some kind of criteria to help him decide which Americans he will see, and which ones he will not see. My bet is that given the huge numbers who want to go over for surgery, he will see the ones who exhibit the most telling signs that they have PN. If Patient A has had no luck with the injections and has not had the testing, while Patient B has had no luck with the injections either, but has had the test (which was high), my guess is that Dr. Robert would be more likely to choose Patient B, and he might tell Patient A to get the testing done.

"My advice is this; if you're going to Houston to get your shots done, go ahead and have the testing done (both sides). Otherwise, if you've got classic PN symptoms and your injections (wherever you get them done) have a positive effect (your pain diminishes or goes away, even temporarily), don't worry about the testing. I know that at least one of our group members has been emailing Dr. Robert recently, and that he was advised by Dr. Robert to get the testing done.

"Anyone who wishes to is completely welcome to refute, comment, or disagree with what I have said here. I've never claimed to be an expert on PN and it is not my intention to cause any of you to "needlessly worry". I am, however, in close contact with most of the doctors who treat PN, both in the U.S. and in France through emailing and phone conversations."

A reply from Greg said:

"Well said Greg......to briefly add to Greg's comment about the Distal Motor Latency Test.....Dr. Shafik, the Egypt PN expert, also fully believes that this test should be performed as part of a diagnostic work up."