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A new pitfall in a sensory conduction study of the lateral antebrachial cutaneous nerve: Spread to the radial nerve
Authors:Chizuko Oishi MD  Masahiro Sonoo MD  Hiroko Kurono MD  Yuki Hatanaka MD  Teruo Shimizu MD  Atsuro Chiba MD  Manabu Sakuta MD
Affiliation:1. Department of Neurology, Faculty of Medicine, Kyorin University, , Tokyo, Japan;2. Department of Neurology, Teikyo University School of Medicine, , Tokyo, 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
Keywords:lateral antebrachial cutaneous nerve  pitfall  radial nerve  sensory nerve conduction study  spread phenomenon
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