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Normal median near nerve potential

W Marques Júnior1, A A Barreira

  • 1Departamento de Neurologia, Psiquiatria e Psicologia Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil.

Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas
|August 1, 1998
PubMed
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This study introduces a new technique to detect signals from thin nerve fibers, improving diagnosis of peripheral neuropathies. This method enhances sensory nerve conduction studies for conditions like leprosy.

Area of Science:

  • Neuroscience
  • Clinical Electrophysiology
  • Neurology

Background:

  • Routine sensory nerve conduction studies (SNCS) analyze nerve fibers ≥ 7 microns.
  • Smaller diameter fibers (< 7 microns) and their contributions to sensory action potentials (SAPs) are typically undetected.
  • This limitation can lead to normal SNCS results in patients with peripheral neuropathies and sensory loss.

Purpose of the Study:

  • To investigate the late component of the median sensory action potential (SAP) using a near-nerve needle electrode technique.
  • To assess the feasibility of detecting signals from thin nerve fibers in peripheral neuropathies.

Main Methods:

  • A near-nerve needle electrode technique was employed in 14 healthy volunteers.
  • Stimulation involved 0.2-ms rectangular pulses at 1 Hz, with intensity at least 6x threshold.

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  • Data acquisition utilized 500–2000 sweep averagings with a specialized amplifier system (≥ 200 MΩ input impedance, ≤ 0.7 μVrms noise).

    • Main Results:

    • The study successfully identified and quantified the late component of the median SAP.
    • Mean values for the late component were: amplitude 0.12 ± 0.04 μV, conduction velocity 16.4 ± 2.95 m/s, and latency 10.6 ± 2.48 ms.
    • The technique demonstrated sensitivity to signals from thinner nerve fibers.

    Conclusions:

    • The described near-nerve needle electrode technique allows for the study of thin fiber neuropathies.
    • This method can be implemented using standard commercial electromyographs, extending diagnostic capabilities beyond academic settings.
    • The technique shows promise for diagnosing conditions like leprosy-related neuropathies.