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

• Published in: Muscle & nerve Vol. 50; no. 2; pp. 186 - 192
• Main Authors: Oishi, Chizuko, Sonoo, Masahiro, Kurono, Hiroko, Hatanaka, Yuki, Shimizu, Teruo, Chiba, Atsuro, Sakuta, Manabu
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-08-2014; Wiley Subscription Services, Inc
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Biophysics; Electric Stimulation; Electromyography; Evoked Potentials - physiology; Female; Healthy Volunteers; Humans; lateral antebrachial cutaneous nerve; Male; Middle Aged; Neural Conduction - physiology; pitfall; radial nerve; Radial Nerve - physiology; sensory nerve conduction study; Skin - innervation; spread phenomenon; Young Adult; radial nerve; lateral antebrachial cutaneous nerve; spread phenomenon; sensory nerve conduction study; pitfall
• ISSN: 0148-639X; 1097-4598
• DOI: 10.1002/mus.24129

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