Setup – Ulnar Motor NCS

Electrode placement (use the bar electrode)

• E1 (black):  Abductor digiti minimi (ADM) muscle (medial side of the hypothenar eminence)
• E2 (red):  Distally along the little finger
• Ground:  Dorsum of hand

Stimulation sites

• Three sites
  • Wrist
    • (-) Cathode (black):  8-cm proximal to E1 along the medial distal forearm.
    • (+) Anode (red):  proximal (in line with the ulnar nerve)
  • Below elbow
    • (-) Cathode (black):  3-4cm distal to the medial epicondyle (ulnar groove)
    • (+) Anode (red):  proximal (in line with the ulnar nerve)
  • Above elbow
    • (-) Cathode (black):  8-10cm proximal to the “below elbow” site (measured with a curved line through the ulnar groove)
    • (+) Anode (red):  proximal (in line with the ulnar nerve)

      

Additional Information

• Type of stimulation = Orthodromic
• If the amplitude is low, move E1 around until you get it over the motor point before calling it truly low.
• 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