Wrist – Digit I, Wrist – Digit II, Wrist – Digit IV

and Mario Di Napoli1



(1)
Neurological Service, S. Camillo de’ Lellis General Hospital, Rieti, Italy

 




Original Settings

Sensitivity, low-frequency filter, high-frequency filter, sweep speed, duration of pulse, rate of pulse, and the machine used were not specified.


Position

This study was performed in the supine position.


Recording

Following the antidromic method [1], the author performed several nerve conduction tests: median–radial nerve latency comparative study to digit I, median–ulnar nerve latency comparative study to digit IV, and median recording to digit III alone. All sensory nerve action potentials (SNAPs) were recorded percutaneously. For median–radial nerve comparative test (Fig. 1), the electrodes were placed over digit I (thumb) at 13 cm from the stimulation of the median and radial nerves, respectively. The author did not specify the exact position of the recording active and reference electrodes. The figure shows the active electrode (A) placed at the base of digit I, 13 cm from the stimulation points at the wrist, for the median (S1) and radial (S2) nerves, respectively. The reference (R) is placed on the distal junction between the proximal phalanx and the distal phalanx. The ground (G) electrode position was not specified in the report; the figure shows the ground electrode placed on the palm. Median (R1) and radial (R2) nerve recordings were made separately (Fig. 2). For median–ulnar nerve comparative test (Fig. 2), the electrodes were placed over digit IV (ring finger) at 13 cm from the stimulation of the median and ulnar nerves, respectively. The author did not specify the exact position of the recording active and reference electrodes. The figure shows the active electrode (A) placed on the junction between the proximal phalanx and the middle phalanx of digit IV, 13 cm from the stimulation points at the wrist, for the median (S1) and ulnar (S2) nerves, respectively. The reference (R) is placed on the junction between the middle phalanx and the distal phalanx of digit IV. Selective recordings to digit I, digit II, and digit IV were performed at 13 cm fixed distance between recording and stimulating sites (Figs. 3, 4, and 5). The ground (G) electrode position was not specified in the report; the figure shows the ground electrode placed on the palm. Median (R1) and ulnar (R2) nerve recordings were made separately.

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Fig. 1
Antidromic sensory nerve action potentials (SNAPs) recorded to digit I, not averaged – single sweep (left), averaged – 8 sweeps (right); median nerve (upper trace) and radial nerve (lower trace), stimulation of the wrist


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Fig. 2
Antidromic sensory nerve action potentials (SNAPs) recorded to digit IV, not averaged – single sweep (left), averaged – 8 sweeps (right); median nerve (upper trace) and ulnar nerve (lower trace), stimulation of the wrist

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May 25, 2017 | Posted by in NEUROLOGY | Comments Off on Wrist – Digit I, Wrist – Digit II, Wrist – Digit IV

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