Nerve conduction normal values for electrodiagnosis in pediatric patients

Abstract

Introduction Existing normal value references for pediatric nerve conduction studies (NCS) are based on limited sample sizes with uncertain reliability, suggesting a need for better normative data. Methods Electronic medical records were reviewed for pediatric patients (0 to <18 years) with normal findings on electromyography and NCS during the period from January 1, 1997 through September 20, 2017. Electrodiagnostic and demographic data were collected. Gaussian and descriptive statistics were used to establish normal values by age group. Results In this study we analyzed 1,918 normal NCS on 1,849 unique pediatric patients. Patients were stratified by age: 0 to <1 month; 1 to <6 months; 6 to <12 months; 12 to <24 months; 2 to <3 years; 3 to <4 years; 4 to <5 years; 5 to <10 years; 10 to <15 years; and 15 to <18 years. Normal reference ranges for amplitude, conduction velocity, and distal latency were established for each age group for 4 motor and 4 sensory nerves. Discussion The large sample size of this study provides reliable reference values for interpreting pediatric NCS. Muscle Nerve 60: 155–160, 2019

Utility and practice of electrodiagnostic testing in the pediatric population: An AANEM consensus statement

“…The AANEM's Normative Data Taskforce established criteria for evaluating articles under consideration as normative standards . Applying those criteria to published pediatric studies yielded seven articles published in peer‐reviewed journals since 1980 that provide high‐quality normative data, from preterm infants to older children (Table ). One additional article with a cohort of 92 children was included as it approached the 100‐patient threshold established by the AANEM task force (Table ).…”

“…The most recent study, with by far the largest cohort, is Ryan et al, which includes data from a large set of 1,918 NCSs performed on 1,849 unique pediatric patients, stratified into multiple age groups. Lower limits for amplitude and conduction velocity, and upper limits for distal latency, were provided for values at the 5th percentile or 95th percentile, respectively (ie, 2 SD below or above the mean).…”

A Systematic Review of the Electrodiagnostic Assessment of Neonatal Brachial Plexus Palsy

“…After excluding duplicate studies and studies in a foreign language from the aforementioned relevant publications, a total of 39 relevant studies were used for this comprehensive review. 21 studies used electrophysiological techniques for NBPP diagnosis and prognosis in clinical scenarios [9,17,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]. Three articles utilized animal models for reporting electrophysiological parameters of avulsed or stretched BP [45][46][47].…”

“…In the first three years of life, the ulnar nerve conduction velocity increased rapidly, while the median nerve conduction velocity slowly increased in the first year of life with a rapid increase in the adolescent years [27]. [27,28,30,33,35,41]. , latency to the start of the potential from stimulus artifact (L1), and latency to peak potential (L2) and B) H-reflex, a late response measure when the stimulus directly stimulates the motor nerve fibers (adapted from [40]).…”

Segmental nerve enlargement in CMT4J

“…Upon the initial encounter, nerve conduction studies were performed, as described previously (Table 1). 3 They showed no response from the right sural sensory and fibular motor nerves. The right median, ulnar, and tibial motor nerve conduction studies showed prolonged distal latencies, slowed velocities, and low to normal amplitudes.…”