The syndrome of detrusor-sphincter dyssynergia is described in a series of patients with a variety of neurological diseases. Bladder function studies using cystometry, sphincter electromyography and electromyelography revealed that sphincter dyssynergia may be associated with detrusor hyperreflexia as well as detrusor areflexia. Impaired function of the pyramidal tracts was documented in all patients and the majority showed impaired segmental innervation of the bladder and urethra.