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On-nerve needle nerve conduction study in the sural nerve: A new technique for evaluation of peripheral neuropathy
Shin J Oh1, Shoji Hemmi2, Yuki Hatanaka3
1Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
Objective:
The objective of this study was to compare the nerve conduction study (NCS) data by the surface electrode (SE)-NCS versus the on-nerve needle (ONN)-NCS and to assess their clinical usefulness in the diagnosis of peripheral neuropathy.
Methods:
Sensory compound nerve action potentials (CNAPs) were obtained by the ONN-NCS with needle electrodes placed on the exposed sural nerve during biopsy in 94 patients with peripheral neuropathy.
Results:
The ONN-NCS is possible in 95% of cases. The ONN-NCS was able to record sensory CNAP in 15% of cases when it was unobtainable in the SE-NCS. The ONN-NCS showed higher amplitude and longer duration of the CNAP but a slower maximum nerve conduction velocity (NCV) than the SE-NCS. The ONN-NCS showed a significantly better concordance with the nerve biopsy findings, especially in demyelinating neuropathy.
Conclusion:
The ONN-NCS is a better electrophysiological test for the histopathological correlation with nerve biopsy.
Significance:
The ONN-NCS was able to record sensory CNAP in 15% of cases when it was unobtainable in the SE-NCS.
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