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Category: Volume 06 Issue 06 June 2018
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Title: Normative Data for Upper Limb Nerve Conduction Study in North India

Authors: Ovais Karnain Wadoo, Surjit Singh, Mariya Rouf Tramboo, Bimal K Agrawal

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i6.26

Abstract

Introduction:  Nerve conduction study assesses peripheral motor and sensory functions by recording the evoked response to electrical stimulation of peripheral nerves. Nerve conduction studies have become a simple and reliable test of peripheral nerve function. With adequate standardization, nerve conduction studies not only identify the lesion but also localize the site of maximal involvement of the nerve. It is important to acquire adequate normative data for an electrophysiological laboratory for working reference as variation due to demographic profile, anthropometric data and laboratory conditions are recorded in literature.

Aim and Objective:  To obtain normative electrophysiological data of Nerve Conduction for Median and Ulnar Nerves of Upper Limb in normal healthy adult individuals of North India.

Material and Method: The study was conducted in the Department of Physiology, Maharishi Markandeshwar Institute of Medical sciences and Research, Mullana (Ambala). The study comprised of 200 healthy subjects between the age group of 16-55 years consisting of equal number of males and females. The equipment used was Allengers Scorpio EMG EP NCS system provided by Allengers Medical System Limited, Chandigarh. Compound Muscle Action potential (CMAP) and Sensory Nerve Action Potential (SNAP) of Median and Ulnar nerve were recorded using standardized technique.

Result and Conclusion: The normal values of various parameters of Nerve conduction study obtained in our study are: Median motor nerve- Latency 3.12±0.39 ms, Amplitude 13.78±2.45 mv, Velocity 56.79±3.68 m/s; Ulnar motor nerve- Latency 2.59±0.39 ms, Amplitude 10.16±1.76 mv, Velocity 56.92±3.67 m/s; Median sensory nerve- Latency 2.53±0.19 ms, 35.15±7.66 µv, Velocity 55.51±4.12 m/s; Ulnar sensory nerve- Latency 2.44±0.22 ms, Amplitude 31.37±6.72 µv, 56.49±3.86 m/s. The results of the present study were compared with the data which has been published in the literature. we found out some differences which could be attributed to a variety of causes which may include Age of the subjects; number of the subjects examined; the laboratory conditions and the equipment used.

From our study, we concluded that it is necessary that each neurophysiological lab needs to have normative data from its own population to be used as reference values for giving reports on abnormal results.

Keywords: Compound muscle action potential, Sensory nerve action potential, Latency, amplitude, Nerve conduction velocity.

References

  1. Bashar katirji. Clinical Neurophysiology. In: Walter GB, Robert BD, Gerald MF, Joseph J, editors. Neurology in clinical practice. 5th New York, Elsevier 2007;483-493.
  2. Allen CML, Lueck CJ, Dennis M. Neurological disease. In: Boon NA, Colledge NR,Walker BR, editors. Davidsons principles and practices of medicine. 20th Philadelphia, Churchill Livingstone 2006;1154-1155.
  3. Misra UK, Kalita J. Nerve Conduction Study. In: Misra UK, Kalita J,editors. Clinical Neurophysiology. 2nd New Delhi, Elsevier 2008;21-28.
  4. Kouyoumdjian JA, zanetta DMT, Monta MPA. Evaluation of age, bodymass index and wrist index as risk factors for carpal tunnel syndrome severity. Muscle Nerve 2002;25(1): 93-97.
  5. Kimura J. Principles and pitfalls of nerve conduction studies. Ann Neurol 1984; 16:415-429.
  6. Aminoff M.J. Clinical electromyography. In Electrodiagnosis in clinical Neurology 4th edition. New York, Churchill Livingstone 1999;214-246.
  7. Falco FJ, Hennessary WJ, Goldberg G, Bradlm RL. Standardized nerve conduction studies in the lower limbs of the healthy elderly. Am J Phys Med Rehabil 1994; 73:168-174.
  8. Soudmand R, Ward LC, Swift TR. Effect of height on nerve conduction velocity. Neurology 1982; 32:407-410.
  9. Robinson LR, Rubner DE, Wohl PW, Fujimoto WY, Stolov WC. Influences of height and gender on normal nerve conduction studies. Arch Phys Med Rehabil 1993; 74:1134-1138.
  10. India reworks obesity guidelines, BMI lowered. 2008 [cited 2011 16th September]; Available from: http://www.igovernment.in/site/India-reworks-obesity-guidelines-BMI- lowered/.
  11. Lee HJ, Delisa JA. Manual of Nerve Conduction Study and Surface Anatomy of Needle Electromyography. 4th Philadelphia, Lippincott Williams & Wilkins 2009: 16.
  12. Shin j Oh. Clinical Electromyography: Nerve Conduction Study. 3rd Philadelphia. Lippincott Williams & Wilkins 2002: 37.
  13. Buschbacher RM, Prahlow ND. Manual of nerve conduction studies. 2nd New York, Demos 2006.
  14. Pawar SM, Taksande AB, Singh R. Normative Data of Upperlimb Nerve Conduction in Central India. Indian j physiol pharmacol. 2011;55(3):241-245.
  15. Pawar SM, Taksande AB, Singh R. Effect of body mass index on Parameters of nerve conduction study in Indian Population. Indian j physiol pharmacol. 2012;56(1):88-93.
  16. Garg R, Bhansal N, Kaur H, Arora KS. Nerve conduction studies in Upper limb in Malwa region-Normative data. J Clin Diagn Res 2013;7(2):201-204.
  17. Shahabuddin S, Badar D, Khan MM, Saimi LB, Solepure AB. normative values for nerve conduction study among healthy subjects from Aurangabad, India. International Journal of Recent Trends in Science and Technology 2013:8(1):56-61.
  18. Wang SH, Robinson LR. Considerations in reference values for nerve conduction studies. Phys Med Rehabil Clin N Am. 1998; 9(4):907-23i.

Corresponding Author

Dr Ovais Karnain Wadoo

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