Ultrasound guidance for sural nerve conduction studies

Abstract

Introduction: Ultrasound can potentially identify nerves and guide recording and stimulating electrode placement for nerve conduction studies (NCS). This prospective study was performed to determine whether ultrasound guidance of sural NCS results in higher action potential amplitude, fewer stimuli required, lower stimulus strength required, and less pain experienced. Methods: Fourteen healthy individuals underwent bilateral sural NCS, both with and without ultrasound guidance. Studies were separated by at least 48 h, and the order of testing was randomly assigned. Results: Ultrasound guidance resulted in significantly fewer stimuli and lower stimuli strength required to obtain supramaximal responses (P < 0.01–0.03). Ultrasound guidance required significantly more time to perform than standard sural NCS (P < 0.01). There was no difference in sural nerve amplitude or pain rating between the 2 groups. Discussion: Neuromuscular ultrasound can be used effectively to guide electrode placement during sural NCS. Muscle Nerve 59:705–707, 2019

Variant Median Nerve Anatomy: Ultrasound Evidence of a Pseudoconduction Block

“…22,23 In conclusion, we reported a patient with a complex medical history, in whom ultrasound visualization identified a rare anomalous course of the median nerve that led to electrodiagnostic abnormalities that caused a pseudoconduction block. This case highlights for neurologists and neuromuscular expects another example of how neuromuscular ultrasound can enhance the reliability of electrodiagnostic studies, minimize technical factors that may potentially lead to misdiagnosis, [24][25][26][27] minimize patient discomfort, and avoid more expensive radiologic testing and evaluation.…”

Portable microcontroller‐based electrostimulation system for nerve conduction studies

“…Follow-up studies should investigate the device validity in several nerves. Future versions of the device could incorporate a sensor to measure skin temperature, and also include a method, such as ultrasound, to identify nerves and guide recording and stimulating electrode placement [27]. Software improvement could include a protocol to define the supramaximal stimulus with an automatic peak detection algorithm, considering that the stimulus intensity is increased by 30% after the CMAP no longer increases [7].…”

Ultrasound First for Pediatric Patients in an Electrodiagnostic Laboratory

“…[6][7][8] In addition, neuromuscular ultrasound can be used to guide electrodiagnostic testing approaches. 5 This is not limited to adults, as studies have also explored the utility of neuromuscular ultrasound in pediatric patients. 9 In our electrodiagnostic laboratory, a recent decision was made to begin performing neuromuscular ultrasound before electrodiagnostic testing in all pediatric patients.…”

“…6–8 In addition, neuromuscular ultrasound can be used to guide electrodiagnostic testing approaches. 5 This is not limited to adults, as studies have also explored the utility of neuromuscular ultrasound in pediatric patients. 9…”

“…Neuromuscular ultrasound is now a frequently used technology in the evaluation of a number of disorders, including neuropathies, motor neuron disease, and myopathies. [3][4][5] The use of neuromuscular ultrasound is supported by a clinical practice guideline, has been shown to improve outcomes for focal neuropathies, and has recently been demonstrated to be a very cost-effective diagnostic modality. [6][7][8] In addition, neuromuscular ultrasound can be used to guide electrodiagnostic testing approaches.…”