Peripheral Neuropathy/Motor Neuron Disease

Nerve            Recording Sites        Stimulation Sites          F-Waves

Median (s)        index and middle        wrist
Ulnar (s)        5th                wrist
Radial (s)        thumb                forearm
Median (m)        APB                wrist and elbow             wrist
Ulnar (m)        ADM                wrist, bel & above elbow    wrist
Sural (s)        ankle                calf
Sup Peron (s)    ankle                leg
Peroneal (m)        EDB                ankle and above knee    ankle
Tibial (m)        AH                ankle and knee        ankle
H-Reflex        soleus                knee

Additional sensory and motor studies may be performed on the contralateral side as needed.

If motor amplitudes are low, perform post-exercise stimulation (10-sec exercise) on distal motor nerves (2-3 nerves) to check for Lambert-Eaton Syndrome.




Needle Examination

Perform needle exam of at least three muscles in two limbs for peripheral neuropathy with sampling of both distal and proximal muscles.  Perform up to 4 extremities (or 3 limbs and facial or tongue muscles including thoracic paraspinal muscles) for motor neuron disease.