Neuromuscular Case Vignettes

Case 5: Nerve conduction study

Sensory nerve studies show absent right median and ulnar, and small, very slow left median SNAP, small radial SNAPs but with normal conduction velocities. Sural responses are within normal range for age. Motor nerve studies diffuse prolongation of distal latencies (more prominent with median nerves), low amplitudes of R.median, ulnar and bilateral tibial CMAPs, and also note the very slow conduction velocity of right ulnar response at the elbow. 

These abnormalities are consistent with a multifocal neuropathy and possible multiple entrapments (bilateral median at wrists,  right ulnar at elbow). Click here for diagnosis and discussion.