Setup – Tibial Motor NCS

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Stimulate 8-cm proximal to E1 (curved line around medial malleolus)

aka “medial plantar motor

Stimulate 8-cm proximal to E1 (curved line around medial malleolus)

Electrode placement (use the bar electrode)

  • E1 (black):  Abductor hallucis brevis (AHB) muscle (drop off the navicular bone and go 1-cm proximal)
  • E2 (red):  Distally along the long axis of the foot
  • Ground:  Medial ankle (between stimulation and pickup)

Stimulation sites

  • Two sites
    • Ankle (medial)
      • (-) Cathode (black):  8-cm proximal to E1 (measured line curving behind the medial malleolus)
      • (+) Anode (red):  proximal
    • Popliteal fossa (mid)
      • (-) Cathode (black):  Popliteal fossa (middle)
      • (+) Anode (red):  proximal

        Middle of the popliteal fossa

Additional Information

  • Type of stimulation = Orthodromic
  • CPT codes for nerve conduction studies
    • 95900 Nerve conduction, amplitude and latency/velocity study, each nerve; motor, without F-wave study
    • 95903 Nerve conduction, amplitude and latency/velocity study, each nerve; motor with F-wave study
    • 95904 Nerve conduction, amplitude and latency/velocity study, each nerve; motor with F-wave study, each nerve; sensory
    • 95934 H-reflex, amplitude and latency study; record gastrocnemius/soleus muscle
    • 95936 Record muscle other than gastrocnemius/soleus muscle

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