A new pitfall in a sensory conduction study of the lateral antebrachial cutaneous nerve: Spread to the radial nerve

Authors


  • This study was supported by Grants-in-Aid for Scientific Research (19591011 and 23591285) from the Ministry of Education, Science, Sports and Culture of Japan, and by Health and Labour Sciences Research Grants for research on intractable diseases (Neuroimmunological Disease Research Committee) from the Ministry of Health, Labour and Welfare of Japan.

ABSTRACT

Introduction: We describe a previously unreported pitfall, spread of the stimulus at the elbow to the radial nerve, in an antidromic sensory nerve conduction study of the lateral antebrachial cutaneous (LAC) nerve. Methods: Subjects consisted of 80 healthy volunteers, and both sides were examined for each subject. Besides routine recording of the LAC nerve, sensory nerve action potentials (SNAPs) of the radial nerve were recorded distally. Results: The spread phenomenon occurred in 73 of 160 arms (46%), and the SNAP amplitude increased due to contamination of the radial SNAP up to 6.7 times the genuine LAC SNAP. In 10 arms (6%), the spread started before the LAC SNAP was saturated, and the genuine LAC SNAP was unknown due to an anatomical variation in at least 1 arm. Conclusions: Without monitoring distal radial SNAPs, the spread phenomenon will remain unrecognized. This pitfall undermines the reliability of the test. Muscle Nerve 50:186–192, 2014

Ancillary