Difficulties in calculating the motor nerve conduction velocity of the peroneal nerve arise when the extensor digitorum brevis is completely atrophied and does not respond to stimulation. I n these patients, conduction velocity i n the proximal fibers of the peroneal nerve can still be calculated by recording from proximal muscles such as the anterior tibial and peroneus brevis. We established normalvalues by asimple standardized method using 34 subjects.Devi S, Lovelace RE, Duarte N: Proximal peroneal nerve conduction velocity: recording from anterior tibial and peroneus brevis muscles. Ann Neurol 2: [116][117][118][119] 1977 The MethodTo establish norms, conduction velocities of the peroneal nerve were determined by recording at the anterior tibial, peroneus brevis, and extensor digitorum brevis muscles. Members of the staff and their families, without neuromuscular disease, constituted the normal group. All studies were performed using a two-channel electromyograph (TECA Model TE4) with fiberoptic permanent recordings. The stimulus was a square-wave pulse with duration variable between 0.5 and 2 msec delivered with a standard bipolar surface electrode. Recording points over the anterior tibial and peroneus brevis muscles corresponded to an area around the motor point. This point was the position where we obtained the greatest amplitude of the negative phase of the evoked muscle potential (also the steepest deflection). Convenient surface markings, using fixed bony points, were devised for these optimum positions.This procedure enabled us to study both the deep and superficial peroneal nerves. The peroneus longus was rejected in favor of the peroneus brevis because of the difficulty of measuring the distal motor latency accurately. In addition, a longer segment was available for calculating the conduction velocity when the peroneus brevis was used. These studies were performed at constant room temperature (22.2-23.3"C), and due care was taken to prevent leg cooling.For the anterior tibial muscle the recording electrode (a metal plate with a diameter of 32 mm) was placed at the junction of the upper third and lower two-thirds of the line between the tibial tuberosity and the tip of the lateral malleolus. The reference electrode was placed over the medial aspect of the tibia at a position 4 cm distal to the recording electrode (Fig 1). For the peroneus brevis the recording electrode was placed at the junction of the upper two-fifths and lower three-fifths of a line between the head of the fibula and the tip of the lateral malleolus. The reference electrode was placed 4 cm distal on the muscle tendon. The ground was placed o n the subcutaneous surface of the tibia, 3 to 4 cm distal from either reference (Fig 2).Recording from the extensor digitorum brevis was performed according to standard procedures [ l , 51. The peroneal nerve was stimulated from above the head of the fibula, just inside the lateral border of the popliteal space at the level of the midpatella. It was also stimulated below the head of the...
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