Ann Rehabil Med.  2011 Oct;35(5):658-663. 10.5535/arm.2011.35.5.658.

Ulnar Nerve Conduction Study of the First Dorsal Interosseous Muscle in Korean Subjects

• Kim DH

• KMID: 2267227
• DOI: http://doi.org/10.5535/arm.2011.35.5.658

Abstract

OBJECTIVE
To derive normative values for ulnar nerve conduction study of the active recording electrode on the first dorsal interosseous muscle (FDI) and the reference electrode on the proximal phalanx of the thumb. METHOD: Ulnar nerve motor conduction study with FDI and abductor digiti minimi muscle (ADM) recording was performed in 214 hands of 107 healthy subjects. Ulnar NCS was performed with 2 different recording electrode montages (ADM-base of 5th finger; FDI-thumb) and differences in latency and amplitude were compared. Using this technique, the initial positivity of ulnar compound muscle action potential (CMAP) was not observed in any response with FDI recording.
RESULTS
The maximal values for distal motor latency to the ADM and FDI muscle were 3.8 ms and 4.4 ms, respectively. The maximal difference of distal motor latency between the bilateral FDI recordings was 0.6 ms. The maximal ipsilateral latency difference between ADM and FDI was 1.4 ms.
CONCLUSION
Placement of the reference electrode on the thumb results in a CMAP without an initial positivity and the normative values obtained may be useful in the diagnosis of ulnar neuropathy at the wrist.

Keyword

Nerve conduction; Reference electrode; Thumb; Ulnar neuropathies; Wrist

MeSH Terms

Action Potentials
Electrodes
Hand
Muscles
Neural Conduction
Thumb
Ulnar Nerve
Ulnar Neuropathies
Wrist

Figure

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  Fig. 1 The position of the reference electrode in the ulnar motor nerve conduction study with the first dorsal interosseous recording: R1: Olney & Wilbourn's method3, R2: The author's method. A: active electrode, G: ground electrode.

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  Fig. 2 Ulnar compound muscle action potentials with first the dorsal interosseous recording and the same stimulation intensity according to each reference electrode position in a healthy person: (A) Olney & Wilbourn's method3 shows an initial positive deflection (arrow); (B) no initial positive deflection was recorded in any responses obtained by the author's method.

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