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Related Experiment Videos

Neurography: late responses.

Christian Bischoff1

  • 1Department of Neurology and Clinical Neurophysiology, Technische Universität München, Möhlstrasse 28, D-81675 München, Germany. christian.bischoff@neuro.med.tu-muenchen.de

Muscle & Nerve. Supplement
|July 13, 2002
PubMed
Summary
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Incorporating late responses like F waves and H reflexes into nerve conduction studies enhances diagnostic value. These muscle action potentials offer crucial insights into demyelinating neuropathies and peripheral nerve lesions.

Area of Science:

  • Neurophysiology
  • Clinical Electromyography
  • Neurology

Background:

  • Routine nerve conduction velocity (NCV) studies are fundamental in diagnosing neurological disorders.
  • The diagnostic yield of NCV can be significantly improved by analyzing late responses.
  • Late responses, including F waves, H reflexes, and intermediate late discharges, provide unique clinical information.

Purpose of the Study:

  • To describe the techniques for eliciting various late responses.
  • To outline the physiological and pathological occurrence of these responses.
  • To highlight the clinical implications and diagnostic utility of late responses in neurophysiological assessments.

Main Methods:

  • Detailed description of electrophysiological techniques to elicit F waves, H reflexes, and intermediate late discharges.

Related Experiment Videos

  • Analysis of the origins and configurations of different late responses.
  • Correlation of late response findings with specific neurological conditions.
  • Main Results:

    • F waves, originating from alpha-motor neuron recurrent discharges, are valuable for diagnosing demyelinating neuropathies and proximal peripheral nerve lesions.
    • H reflexes, analogous to the stretch reflex, are primarily useful in sacral plexopathies, S1 radiculopathy, and polyneuropathies.
    • Intermediate late discharges, including A waves, can indicate early signs of acute inflammatory demyelinating neuropathy, such as Guillain-Barré syndrome.

    Conclusions:

    • The inclusion of late responses substantially increases the meaningfulness and diagnostic accuracy of routine conduction velocity studies.
    • Understanding the distinct characteristics and origins of late responses is critical for accurate clinical interpretation.
    • Late responses serve as important electrodiagnostic markers for a range of peripheral nervous system disorders.