Scribd
Upload
177 views28 pages

Nerve Conduction Velocity

Nerve conduction velocity tests measure the speed at which nerves conduct electrical impulses. They are used to determine nerve injury or muscle disease. The tests involve stimulating nerves at two points and measuring the latency of the response to calculate conduction velocity. Common nerves tested include the median, ulnar, and posterior tibial nerves. The tests provide information about nerve functioning and can help diagnose neuropathies.

Uploaded by

Sheron Mathew
Copyright
© © All Rights Reserved
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
Download as ppt, pdf, or txt
177 views28 pages

Nerve Conduction Velocity

Nerve conduction velocity tests measure the speed at which nerves conduct electrical impulses. They are used to determine nerve injury or muscle disease. The tests involve stimulating nerves at two points and measuring the latency of the response to calculate conduction velocity. Common nerves tested include the median, ulnar, and posterior tibial nerves. The tests provide information about nerve functioning and can help diagnose neuropathies.

Uploaded by

Sheron Mathew
Copyright
© © All Rights Reserved
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
Download as ppt, pdf, or txt
Download as ppt, pdf, or txt
You are on page 1/ 28

Nerve Conduction

Velocity
 It was developed first in 1948

 NCV tests are used to determine the speed


with which a peripheral motor or sensory
nerve conducts an impulse
 Itis one of the imp diagnostic procedure
that provides information about the
extent of nerve injury or muscle disease

 Done on any peripheral nerve that is


superficial enough to be stimulated
through the skin at two different points
CONDUCTION VELOCITY
 Velocity = Distance/Time
 CMAP (Compound Motor Action
Potential)- MNCV
 SNAP (Sensory Nerve Action Potential)-
SNCV
 CV= D/PL-DL
 CV- m/sec
 Measurement of latency difference
eliminates the effects of residual
latency
CONTRAINDICATIONS

 Cardiac pacemakers
 Cardiac catheters
 Central venous pressure lines
ELECTRODES
 Stimulating Electrode

 Bipolar electrode
extending from plastic
casing
ELECTRODES
 Ground electrode  Green color
 Absorbs other waves
from environment
Surface electrodes are used to
record the evoked potentials
 Surface Electrodes Sensory or Ring Electrodes
MNCV
 COMMONLY TESTED NERVES
 Ulnar nerve – Abductor digiti minimi
 Median nerve - Abductor pollicis brevis
 Common Peroneal nerve – Extensor digitorum
brevis
 Posterior Tibial nerve – Abductor halluces
 Less commonly tested:-
 Radial nerve
 Femoral nerve
 Sciatic nerve
Technique of Application
 Skin should be cleaned
 Distal muscle innervated by a nerve is selected
 Active recording –over belly -cathode
 Reference recording –over tendon –anode
 Ground electrode -over neutral area between electrodes
 Stimulating electrode -placed such that cathode directed
towards recording electrodes
 For accurate measurement, distance between 2 points of
stimulation should be at least 10 cm. reduces the error due to
faulty distance measurement
MNCV

 Median nerve - APB


CMAP

Onset latency- time in ms from the stimulus artifact to 1st negative


deflection of CMAP
CALCULATION
 Motor march- proximal to distal
 For sensory- distal to proximal
 Orthodromic- normal
physiological pathway
 Antidromic – opp. To NPP
SENSORY NCV
 Sensory conduction can be measured
orthodromically or antidromically
 Orthodromic–distal portion of nerve is
stimulated and SNAP is recorded at a
proximal point along the nerve
 Antidromic–nerve is stimulated
proximally and SNAP recorded distally
 COMMONLY TESTED NERVES
 MEDIAN NERVE
 ULNAR NERVE
 SURAL NERVE
 MEDIAL AND LATERAL PLANTER NERVES
SNCV
SNAP
PARAMETERS
 Latency
 Orthodromic latency < antidromic latency
 Amplitude
 Antidromic amplitude > orthodromic amplitude
 Duration
 Residual latency not applicable to sensory N conduction
 Distance = between stimulating & recording site ( single
stimulation site) in mm
 Shape
 Antidromic potential- initial positivity absent
VARIABLES AFFECTING NCV

 PHYSIOLOGICAL VARIABLES
 Age
 Upper limb versus lower limb
 Temperature
 Myelination
 Diameter of axon
VARIABLES AFFECTING NCV

 TECHNICHAL VARIABLES
 Stimulating system
 Recording system
 Stimulation of unintended nerves
 Anomalous Crossover
F-WAVE

 F-wave was first described by Magladary and McDougal


in 1950.
 It is elicited by supramaximal stimulation.
 Only conducted from motor nerve.
 It is used to diagnose the condition where more
proximal axon is involved.
F-WAVE
F-WAVE

 Also used in pharmacological studies of spasticity as a


measure of alpha motor neuron excitability.
 Normal value of latency :
Upper limb - 30 ms
Lower limb – 60 ms
 Take 10 successive trials.
H-REFLEXES

 Also called Hoffmann’s reflex.


 It is useful for radiculopathy and peripheral neuropathy.
 Used in testing the integrity of the sensory and motor
monosynaptic pathways of S1 nerve roots, and to a
lesser extent at C6 and C7.
 Submaximal stimulus is applied.
H-REFLEXES
H-REFLEXES

 Elicited in
Soleus
Flexor carpi radialis
 H-reflex latency = 0.46 (leg length in cm) + 9.14 + 0.1
(Age in year)
Standard variation +5.5ms
 Normal value :- 29.8 ms + 2.74 ms
H-REFLEXES

 Slow latency is indicative of abnormal dorsal root


function.

You might also like