Ann Rehabil Med.  2019 Feb;43(1):74-80. 10.5535/arm.2019.43.1.74.

Could Ultrasound-Guided Stimulation of Sural Nerve Affect Nerve Conduction Study?

  • 1Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Seoul, Korea.
  • 2Radio Technology Research Department, Electronics and Telecommunications Research Institute, Daejeon, Korea.


To determine anatomical variation of the sural nerve (SN) by ultrasonography (US) and compare sensory nerve action potential (SNAP) of the SN obtained by a control method to that obtained with adjusted method using US.
Eighty legs of 40 healthy volunteers were enrolled. The location and formation of SN were investigated through US. Two methods of nerve conduction study (NCS) were then performed. In the control method, the cathode was placed 14 cm proximal to the lateral malleolus and the greatest SNAP amplitude was obtained by moving the cathode medially or laterally from just lateral to the calf-mid line. In adjusted NCS, the exact SN union site was stimulated in type 1. In other SN types, the stimulation was done directly over the nerve and the distance from the lateral malleolus was set to be 14 cm.
It was found that 73.8% of the SNs were type 1, 22.5% were direct continuation of MSCN (type 2), and 3.8% were MSCN and LSCN without communicating (type 4). However, type 3 was not found. The union point in type 1 SN was 12.6±2.5 cm proximal to the lateral malleolus and 1.4±0.7 cm lateral to the calf-midline. After stimulation adjustment, SNAP amplitude in type 1 SN was significantly increased (20.7±5.5 μV vs. 27.1±6.7 μV).
Anatomical variation of SN and its location were verified by US. US provides additional information for conducting sural NCS and helps obtain more accurate results.


Sural nerve; Nerve conduction study; Ultrasonography

MeSH Terms

Action Potentials
Healthy Volunteers
Neural Conduction*
Sural Nerve*
Full Text Links
  • ARM
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2022 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: