General rules
Velocity
|
|
Normal |
Demyelinating (75%LLN) |
|
Velocity UL |
>50 |
<35 |
|
Velocity LL |
>40 |
<30 |
|
F-M UL |
<28 |
>36 |
|
F-M-LL |
<50 |
>65 |
Conduction block
· Probable if 30% decrease in area or amplitude
· Definite in 50% decrease in area or amplitude
Upper Limb - Motor
|
Stimulation point |
Recording point |
Dist - mm |
Amp - mV |
Lat - ms |
Vel. m/s |
F-waves ms |
F-M latency ms |
Comments |
|
Median |
|
|
|
|
|
|
|
|
|
Wrist |
APB |
70 |
5 [>60yrs =3.8] |
4.7 (4.2) [4.5] |
49 |
31 (32) |
(28) |
Right-Left amplitude difference <3mV Median-Ulnar TML <1.5 ms
, Right-Left TML <0.8 ms |
|
Wrist |
2nd Lumbrical |
80 |
Median-Ulnar < 0.5 msec difference |
|||||
|
Ulnar |
|
|
|
|
|
|
|
|
|
Wrist |
ADM |
60 |
6 |
3.5 |
49 |
31 (32) |
(27.5) |
Right-Left <3ms
Median-Ulnar <1.5 ms Right-Left TML <0.8 ms |
|
Above elbow |
ADM |
100 |
6 |
40 |
Across elbow cf forearm 10 drop (10-15
borderline, >15 abnormal) |
|||
|
Wrist |
FDI |
(4.8) |
Right-Left <1 ms |
|||||
|
Radial |
|
|
|
|
|
|
|
|
|
Wrist |
2nd palmar interosseous |
80 |
Median-Ulnar < 0.5 msec difference |
|||||
|
Forearm |
EIP |
(30) |
52 |
Right-Left <50% amplitude |
||||
|
Upper arm |
EIP |
58 |
Lower Limb - Motor
|
Stimulation point |
Recording point |
Dist - mm |
Amp - mV |
Lat - ms |
Vel. m/s |
F-waves ms |
F-M latency ms |
Comments |
|
Peroneal |
|
|
|
|
|
|
|
|
|
Ankle |
EDB |
80 |
2.5 |
5.5 |
40 |
56 (55) |
(49) |
Right-Left <7ms (<3 ms) |
|
2 |
7 |
38 |
Age >65 (60) |
|||||
|
Knee |
EDB |
(3.5) |
(45) |
Age (<60) |
||||
|
Knee |
EDB |
(3.5) |
(42) |
Age (>60) |
||||
|
Fibular neck |
Tibialis anterior |
? |
||||||
|
Knee |
Tibialis anterior |
? |
? |
44 |
||||
|
Tibial |
|
|
|
|
|
|
|
|
|
Ankle |
Abductor hallucis |
80 |
4 |
5.8 |
41 (39) |
58 (59) |
(53) |
Right-Left <7 (<3) |
|
Ankle |
Abductor hallucis |
80 |
4 |
6 |
40 (37) |
Age >65 (60) |
||
|
Knee |
Soleus |
(160) |
H-reflex Latency <34ms H-M
latency (<30ms) Right-Left <1.5 (<2.5) |
|||||
|
Femoral |
|
|
|
|
|
|
|
|
|
Inguinal ligament |
Rectus femoris |
120 |
Right-Left <50% amplitude |
|||||
|
Inguinal ligament |
Rectus femoris - distal |
(120) |
50 |
|||||
|
Inguinal ligament |
Vastus medialis |
Right-Left <1.5 ms |
Non-Standard
|
Nerve |
Stimulation point |
Recording point |
Distance - mm |
Comments |
Amp - mV |
Lat - ms |
Vel. m/s |
F-waves ms |
F-M latency ms |
|
Musculocutaneous |
Erb point |
Biceps |
Right-Left <50% amplitude and * |
||||||
|
Axillary |
Erb point |
Deltoid |
Right-Left <50% amplitude and * |
||||||
|
Suprascapular |
Erb point |
Supraspinatus |
Right-Left <50% amplitude and * |
||||||
|
Suprascapular |
Erb point |
Infraspinatus |
Right-Left <50% amplitude and * |
||||||
|
Accessory |
Posterior triangle |
Trapezius |
Right-Left <50% amplitude and * |
||||||
|
Phrenic |
Cervical region |
Diaphragm |
|
||||||
|
Tibial H reflex |
Popliteal fossa |
Gastrocnemius |
160 |
Compare sides |
|||||
|
Tibial H reflex |
Popliteal fossa |
Soleus |
160 |
Compare sides |
|||||
|
Median H-reflex |
FCR |
Above elbow |
Compare sides |
||||||
|
* Rough calculation latency -1 > 50 m/sec |
Sensory
|
Stimulation point |
Recording point |
Distance - mm |
Amplitude - μV |
Latency - ms |
Velocity m/s |
Comments |
|
Median |
|
|
|
|
|
|
|
Palm |
Wrist |
80 |
10 |
2.2 |
Median - Ulnar <0.2 (0.3) difference |
|
|
D1 (orthodromic) |
Wrist |
100 |
(6) |
(3.2) |
(50) |
|
|
D2 (orthodromic) |
Wrist |
130 |
(8) |
(3.2) |
||
|
D3 (orthodromic) |
Wrist |
130 |
(8) |
(3.2) |
||
|
D4 (orthodromic) |
Wrist |
130 |
Median - Ulnar <0.5 msec difference |
|||
|
Ulnar |
|
|
|
|
|
|
|
Palm |
Wrist |
80 |
5 |
2.2 |
Median - Ulnar <0.2 (0.3) difference |
|
|
D5 (orthodromic) |
Wrist |
110 |
6 |
50 |
||
|
D4 (orthodromic) |
Wrist |
130 |
Median - Ulnar <0.5 msec difference |
|||
|
Ulnar dors cut br |
|
|
|
|
|
|
|
Dorsum hand |
Wrist (orthodromic) |
110 |
||||
|
Digit 5 |
Wrist (orthodromic) |
|||||
|
Radial |
|
|
|
|
|
|
|
Above wrist |
Snuffbox |
80 |
17 |
2.6 |
50 |
age 20 |
|
Above wrist |
Snuffbox |
80 |
9 |
2.9 |
age 60 |
|
|
D1 (orthodromic) |
Above wrist |
100 |
8 |
(50) |
||
|
FDI space (orthodromic) |
Above wrist |
100 |
14 |
(50) |
||
|
Lat cut n of forearm |
|
|
|
|
|
|
|
Elbow |
Forearm (anti) |
120 |
15 |
3 |
age 20 |
|
|
Elbow |
Forearm |
120 |
9 |
2.5 |
age 60 |
|
|
Med cut n of forearm |
|
|
|
|
|
|
|
Elbow |
Forearm (anti) |
120 |
9 |
2.5 |
age 20 |
|
|
Elbow |
Forearm |
120 |
4 |
3.5 |
age 60 |
|
|
Sural |
|
|
|
|
|
|
|
Calf |
Ankle |
140 |
6 |
4.4 |
42 (40) |
age 20 |
|
Calf |
Ankle |
140 |
3 |
4.6 |
36 |
age 60 |
|
Superficial peroneal |
0 |
age >65 |
||||
|
Calf |
Foot |
140 |
6 |
4.3 |
40 |
age 20 |
|
Calf |
Foot |
140 |
3 |
4.6 |
40 (38) |
age 60 |
|
Medial plantar |
0 |
age >65 |
||||
|
Sole |
Ankle |
140 |
6 |
? |
(38) |
age 20 Right - Left <0.4 ms |
|
Sole |
Ankle |
140 |
3 |
? |
(36) |
age 60 |
|
Lat cut n of thigh |
|
|
|
|
|
|
|
Below Inguinal ligament |
Thigh |
140 |
50 |
(70% present, note referral fo paraesthesiae) |
||
|
Med cut n of thigh |
|
|
|
|
|
|
|
Below Inguinal ligament |
Thigh |
140 |
||||
|
Post cut n of thigh |
||||||
|
Deep peroneal |
|
|
|
|
|
|
|
Foot (orthodromic) |
Ankle |
?120 |
||||
|
Saphenous |
|
|
|
|
|
|
|
Lower leg (orthodromic) |
Leg |
140 |
Side to side comparison |
Sensory Antidromic
|
Nerve |
Stimulation point |
Recording point |
Distance - mm |
Amplitude - μV |
Latency - ms |
Velocity m/s |
Comments |
|
|
Median |
Wrist |
D4 (antidromic) |
130 |
? |
? |
? |
Median - Ulnar <0.5 msec difference |
|
Median |
Wrist |
D1 (antidromic) |
100 |
? |
2.9 |
Median - Radial <0.5 msec difference |
|
|
Median |
Wrist |
D2 (antidromic) |
130 |
19 |
3.4 |
50 |
age 20 |
|
Median |
Wrist |
D2 (antidromic) |
130 |
9 |
3.8 |
age 60 |
|
|
Ulnar |
Wrist |
D5 (antidromic) |
110 |
17 |
3.1 |
49 |
age 20 |
|
Ulnar |
Wrist |
D5 (antidromic) |
110 |
4 |
3.3 |
age 60 |
|
|
Ulnar |
Wrist |
D4 (antidromic) |
130 |
Median - Ulnar <0.5 msec difference |
|||
|
Ulnar dors cut br |
Wrist (antidromic) |
Dorsum hand |
110 |
||||
|
Radial |
Wrist |
D1 (antidromic) |
100 |
2.8 |
|||
Muscle and Nerve 2016
