Sural and Saphenous 14-cm Antidromic Sensory Nerve Conduction Studies

Abstract

Buschbacher RM: Sural and saphenous 14-cm antidromic sensory nerve conduction studies. Am J Phys Med Rehabil 2003;82:421-426. Objective: To create a large database of normal values for the sural and saphenous nerve conduction studies and to compare the results for the two nerves.Design: Using a 14-cm antidromic technique, data were collected for onset latency, peak latency, onset-to-peak amplitude, peak-to-peak amplitude, area, duration, side-to-side variability, and between-nerve variability. A total of 230 subjects were included in the study.Results: For the sural nerve, the upper limits of normal, defined as the 97th percentile of observed values, for onset latency, peak latency, and duration were 3.6, 4.5, and 2.1 msec, respectively. The comparable values for the saphenous nerve were 3.8, 4.4, and 1.9 msec, respectively. The lower limits of normal (third percentile) for sural onset-topeak amplitude and peak-to-peak amplitude were 4 and 4 V. The comparable values for the saphenous study were 2 and 1 V. The upper limit of normal difference in onset latency between the two nerves was: saphenous 0.7 msec longer than sural or sural 0.3 msec longer than saphenous. The corresponding values for peak latency were: 0.6 and 0.5 msec.Conclusion: Normal ranges are presented for a large database of subjects for the sural and saphenous nerve conduction studies.

A Novel Sensory Nerve Conduction Study Technique to Evaluate the Sural Nerve From the Forefoot to the Knee

“…Anatomic localization of the sural nerve for the purpose of nerve conduction study at the distal calf, ankle, and forefoot is well described in the literature (Buschbacher, 2003;Schuchmann, 1977). In contrast, surface anatomic landmarks of the sural nerve in the upper calf and at the level of the knee are less commonly described.…”

The Scapholunate Interosseous Ligament Afferent Proprioceptive Pathway: A Human In Vivo Experimental Study

“…Based on previous studies concerning orthodromic conduction velocity in the upper limb and the various types of nerve fibers studied (Ia, Ib, and II), the safe interelectrode distance was calculated to be 4 cm. [13][14][15][16][17][18][19][20][21][22][23][24] Interference from the activity of different nerves on the recording electrodes of a single nerve was negligible because the SAP intensities of the examined nerves were almost untraceable at the mid-distance of each nerve pair.…”

Developing reference data for nerve conduction studies: An application of quantile regression

“…This is the issue that lies at the heart of this study. These statistical methods lack satisfactory capacity to adjust for covariates, such as age and gender, which from our experience as well as that in the literature may heavily influence NCS results 5, 6, 9, 10, 12, 16–20. For the purpose of generating reference data for use in clinical practice, statistical methods that do not allow for covariate adjustment will, therefore, not suffice.…”

“…These statistical methods lack satisfactory capacity to adjust for covariates, such as age and gender, which from our experience as well as that in the literature may heavily influence NCS results. 5,6,9,10,12,[16][17][18][19][20] For the purpose of generating reference data for use in clinical practice, statistical methods that do not allow for covariate adjustment will, therefore, not suffice. Among such methods, the most commonly employed is perhaps that which uses the mean AE some number of standard deviations (SD) to define the upper and lower bounds of the reference range assuming that data follow a bell-shaped normal distribution.…”