Nerve |
Variable |
DML (ms) |
Distal CMAP (mV) |
MNCV (m/s) |
FWL (ms) |
Peak SNL (ms) |
SNAP (µV) |
SNCV (m/s) |
P value |
Median |
Right side |
3.38 (0.38) |
10.62 (2.8) |
54.19 (5.15) |
24.95(3.37) |
3.5 (0.41) |
32.2(14.2) |
54.7(6.7) |
0.8 |
|
Left side |
3.37 (0.37) |
10.54 (2.7) |
54.5 (6.2) |
24.6 (3.03) |
3.5 (0.4) |
33.8(14.5) |
54.4 (6.4) |
|
|
< 18 years |
2.9 (0.54) |
10.64(2.97) |
55.46(6.9) |
21.1 (5.4) |
3.01 (0.65) |
41.3(10.8) |
57.2(8.3) |
0.000 |
|
19-49 yrs |
3.3(0.34) |
11.1(2.8) |
55.1(5.3) |
24.4(3.3) |
3.4(0.37) |
36.6(15.3) |
55.5(6.3) |
|
|
50-79 yrs |
3.5(0.36) |
9.9(2.5) |
53.4(5.6) |
25.5(2.4) |
3.6(0.38) |
27.5(10.9) |
53.3(6.5) |
|
|
> 80 years |
3.8(0.1) |
6.2(1.9) |
44.8(14.1) |
25.7(7.1) |
3.9(0.43) |
18.4(4.01) |
48.3(3.02) |
|
|
Male |
3.5(0.37) |
10.4(2.6) |
54(5.9) |
25(3.2) |
3.5(0.37) |
31.4(13.6) |
54.7(6.05) |
0.000 |
|
Female |
3.3(0.37) |
10.7(2.8) |
54.6(5.5) |
24.6(3.2) |
3.5(0.43) |
34(14.8) |
54.5(6.86) |
|
Total (493) |
|
3.4(0.37) |
10.6(2.75) |
54.4(5.7) |
24.8(3.2) |
3.5(0.4) |
32.95(14.4) |
54.6(6.5) |
|
Ulnar |
Right side |
2.7(0.38) |
9.9(2.2) |
59.6(8.2) |
25.9(3.5) |
3.1(0.48) |
29.8(14.3) |
53.9(6.9) |
0.7 |
|
Left side |
2.8(0.4) |
9.2(2.2) |
59.9(7.8) |
25.8(3.2) |
3.08(0.38) |
29.7(12.2) |
53.9(6.7) |
|
|
< 18 years |
2.7(0.65) |
8.6(3.0) |
59.9(7.2) |
22.6(5.8) |
2.8(0.75) |
35.9(11.6) |
54.9(9.3) |
0.000 |
|
19-49 yrs |
2.7(0.37) |
10.1(2.2) |
61(7.2) |
25.2(3.09) |
3.04(0.37) |
32(13.0) |
54.6(6.4) |
|
|
50-79 yrs |
2.8(0.39) |
8.9(1.95) |
58.1(8.8) |
26.9(3.2) |
3.2(0.49) |
26.3(13.2) |
53(7.1) |
|
|
> 80 years |
3.2(0.34) |
8.05(1.1) |
52.4(7.0) |
29.8(0.96) |
3.4(0.31) |
20(7.9) |
47.2(4.0) |
|
|
Male |
2.9(0.4) |
9.39(2.2) |
58.4(7.9) |
26.2(3.8) |
3.09(0.44) |
28.5(13.6) |
54.2(5.9) |
0.5 |
|
Female |
2.7(0.36) |
9.7(2.2) |
60.8(7.9) |
25.5(2.98) |
3.1(0.44) |
30.7(13.1) |
53.7(6.7) |
|
Total (493) |
|
2.75(0.39) |
9.6(2.2) |
59.8(7.98) |
25.8(3.4) |
3.1(0.44) |
29.75(13.4) |
53.9(6.8) |
|
peroneal |
Right side |
3.8(0.75) |
6.04(1.9) |
46.6(4.2) |
45.8(4.4) |
|
|
|
|
|
Left side |
3.9(0.73) |
5.9(1.96) |
46.7(4.6) |
45.6(4.9) |
|
|
|
|
|
< 18 years |
3.8(1.3) |
5.3(2.04) |
45.8(3.95) |
35.1(6.95 |
|
|
|
0.000 |
|
19-49 yrs |
3.9(0.75) |
6.3(2.09) |
47.4(4.7) |
45.4(4.2) |
|
|
|
|
|
50-79 yrs |
3.8(0.69) |
5.8(1.8) |
46.3(4.09) |
46.5(4.13) |
|
|
|
|
|
> 80 years |
4.2(0.86) |
55.7(1.9) |
40.3(2.4) |
49.7(1.3) |
|
|
|
|
|
Male |
3.94(0.75) |
6.2(2.03) |
45.98(4.6) |
46.3(5.08) |
|
|
|
0.8 |
|
Female |
3.7(0.72) |
5.8(1.8) |
47.3(4.1) |
45.2(4.2) |
|
|
|
|
Total (477) |
|
3.8(0.74) |
5.99(1.9) |
46.6(4.4) |
45.7(4.7) |
|
|
|
|
Tibial |
Right side |
3.9(0.78) |
9.9(3.3) |
45.8(5.3) |
47.3(4.3) |
|
|
|
0.8 |
|
Left side |
3.9(0.73) |
10.8(3.7) |
45.8(5.1) |
48(4.6) |
|
|
|
|
|
< 18 years |
3.6(0.56) |
13.3(4.3) |
45.98(3.4) |
36.9(6.4) |
|
|
|
0.000 |
|
19-49 yrs |
3.9(0.73) |
11.2(3.7) |
46.4(5.06) |
47.2(3.7) |
|
|
|
|
|
50-79 yrs |
3.94(0.76) |
9.5(3.2) |
45.3(5.4) |
48.6(4.0) |
|
|
|
|
|
> 80 years |
4.44(1.3) |
8.43(1.1) |
43.2(2.8) |
49.6(3.6) |
|
|
|
|
|
Male |
3.9(0.77) |
10.6(3.6) |
45.5(4.85) |
47.6(4.7) |
|
|
|
0.4 |
|
Female |
3.9(0.74) |
9.98(3.4) |
46.03(5.5) |
47.7(4.1) |
|
|
|
|
Total(477) |
|
3.9 (0.75) |
10.3 (3.5) |
45.8(5.2) |
47.7(4.4) |
|
|
|
|
Sural |
Right side |
|
|
|
|
2.5(0.5) |
19.4(8.3) |
74.1(10.9) |
|
|
Left side |
|
|
|
|
2.6(0.44) |
19.2(8.8) |
72.7(11.6) |
|
|
< 18 years |
|
|
|
|
2.7(0.68) |
23.9(7.46) |
61.2(9.1) |
0.000 |
|
19-49 yrs |
|
|
|
|
2.6(0.55) |
20.5(8.8) |
72.6(12.3) |
|
|
50-79 yrs |
|
|
|
|
2.5(0.38) |
18.2(8.2) |
74.8(10.2) |
|
|
> 80 years |
|
|
|
|
2.75(0.19) |
12.7(4.6) |
70.4(2.5) |
|
|
Male |
|
|
|
|
2.6(0.5) |
19.03(9.9) |
72.6(11.08) |
0.5 |
|
Female |
|
|
|
|
2.5(0.43) |
19.5(7.02) |
74.2(11.4) |
|
Total (477) |
|
|
|
|
|
2.53 (0.47) |
19.3(8.5) |
73.4(11.3) |
|
Table 1: Distribution of Mean (SD) of various nerve conduction parameters according to age, gender and side
Yrs – years, DML – Distal Motor Latency, CMAP – Compound Muscle Action Potential, MNCV – Motor Nerve Conduction Velocity, FWL – F Wave Latency, SNL – Sensory Nerve Latency, SNAP – Sensory Nerve Action Potential, SNCV – Sensory Nerve Conduction Velocity, ms – milliseconds, mV – millivolts, m/s – meter per seconds, µV – micro-volts.Study [ref] |
Mean (SD) of median nerve DML (ms) |
Mean (SD) of ulnar nerve DML (ms) |
Mean (SD) of Median Nerve CMAP (mV) |
Mean (SD) of Ulnar nerve CMAP (mV) |
Mean (SD) of Median MNCV |
Mean (SD) of Ulnar MNCV |
Mean (SD) of median FWL (ms) |
Mean (SD) of ulnar FWL (ms) |
Wadoo OK, et al. [9] |
3.12±0.39 |
2.59±.39 |
13.78±2.45 |
10.16±1.76 |
56.79±3.68 |
56.92±3.67 |
- |
- |
Pawar, et al. [10] |
3.25±0.5 |
2.31±.38 |
14.00±4.08 |
13.05±2.76 |
56.33±4.57 |
58.13±4.7 |
25.5 |
26.09 |
Robinson, et al. [11] |
3.6±0.4 |
2.9±0.4 |
9.5±2.9 |
8.4±2.1 |
54.4±3.8 |
56.3±6.2 |
- |
- |
Kimura J, et al. [12] |
3.49±34 |
2.59±.39 |
7.0±3.0 |
5.7±2.0 |
57.7±4.9 |
58.7±5.1 |
26.6 |
27.6 |
Shahabuddin [13] |
3.18±61 |
2.45±.34 |
11.79±.59 |
11.26±1.07 |
53.59±0.6 |
55.72±3.24 |
- |
- |
Shehab DK [14] |
3.1±0.3 |
2.4±0.3 |
11.1±2.8 |
9.2±2.2 |
56.5±3.5 |
60.4±52 |
- |
- |
Misra and Kalita [15] |
3.49±0.34 |
2.59±0.4 |
7.0±3.0 |
8.51±2.03 |
57.7±4.9 |
61.45±5.73 |
|
|
Hennessey, et al. [16] |
3.2±0.4 |
2.6±0.3 |
12.1±3.8 |
12.6±2.3 |
59.5±4.4 |
63±4.8 |
- |
- |
Falco, et al. [17] |
3.5±0.5 |
2.7±0.3 |
9.2±3.1 |
9.9±1.8 |
54.4±5.4 |
61.1±4.1 |
- |
- |
DeLisa, et al. [18] |
3.7 |
3.2 |
13.2 |
6.14 |
56.7 |
61.8 |
29.1 |
30.5 |
Oh SJ [19] |
2.78 |
2.03 |
>5 |
>5 |
58.78 |
61.15 |
25.32 |
25.68 |
Current study |
3.38±0.38 |
2.74±.38 |
10.58±2.8 |
9.57±2.22 |
54.35±6.05 |
59.78±8.18 |
24.8±3.4 |
25.8±3.5 |
Table 2: Comparative analysis of Mean (SD) of upper limb motor conduction.
DML – Distal Motor Latency, CMAP – Compound Muscle Action Potential, MNCV – Motor Nerve Conduction Velocity, FWL – F Wave Latency, ms – milliseconds, mV – millivolts, m/s – meter per seconds.
Study (ref) |
Mean (SD) of Peroneal nerve DML |
Mean (SD) of tibial nerve DML |
Mean (SD) of Peroneal Nerve CMAP |
Mean (SD) of Tibial nerve CMAP |
Mean (SD) of Peroneal motor CV |
Mean (SD) of Tibial motor CV |
Mean (SD) of Peroneal f wave latency |
Mean (SD) of Tibial f wave latency |
Kimura J, et al. [12] |
3.7±0.86 |
3.9±1.0 |
5.1±2.3 |
3.8±1.9 |
48.3±3.9 |
48.5±3.6 |
- |
- |
Shahabuddin, et al. [13] |
4.14±0.36 |
4.77±.036 |
5.37±.097 |
4.77±.036 |
49.01±9.03 |
45.52±3.04 |
- |
- |
Misra and Kalita [15] |
4.55±0.59 |
3.9±0.5 |
4.23±1.61 |
- |
46.54±4.4 |
48.3±4.5 |
- |
- |
Shehab DK [14] |
3.95±0.54 |
4.2±0.8 |
- |
- |
48.2±2.8 |
46.95±3.35 |
- |
- |
Current study |
4.83±0.74 |
3.91±o.75 |
5.99±1.93 |
10.3±3.5 |
46.65±4.41 |
45.77±5.2 |
45.74±4.67 |
47.65±4.43 |
Table 3: Comparative analysis of Mean (SD) of lower limb motor conduction
DML – Distal Motor Latency, CMAP – Compound Muscle Action Potential, MNCV – Motor Nerve Conduction Velocity, FWL – F Wave Latency, ms – milliseconds, mV – millivolts, m/s – meter per seconds.
Sensory conduction Study (ref) |
Median Peak SNL |
Median SNAP |
Median SNCV |
Ulnar peak SNL |
Ulnar SNAP |
Ulnar SNCV |
Sural Peak SNL |
Sural SNAP |
Sural SNCV |
Misra and Kalita [15] |
3.06±0.41 |
8.91±4.48 |
45.45±9.4 |
2.83±0.40 |
5.54±2.37 |
54.17±6.1 |
-- |
18.0±10.5 |
50.9±5.4 |
Johnson and Melvin [20] |
-- |
-- |
-- |
3.2±0.25 |
-- |
57±5.0 |
|
|
|
Kimura et al [12] |
2.84±0.34 |
38.5±15.6 |
56.2±5.8 |
2.54±0.29 |
35±14.7 |
54.8±5.3 |
|
|
|
Shehab DK et al [14] |
|
|
|
|
|
|
2.8±0.27 |
|
50.1±5.45 |
Shahabuddin s et al [13] |
03.05 ± 0.55 |
35.21±5.5 |
56.93±3.5 |
2.90 ± 0.36 |
26.73± 0.48 |
56.52± 0.48 |
2.47± 0.57 |
15.63±3.47 |
50.02±3.45 |
Current study |
3.5±0.4 |
32.95±14.4 |
54.6±6.5 |
3.1±0.44 |
29.75±13.4 |
53.9±6.8 |
2.53±0.47 |
19.3±8.5 |
73.4±11.3 |
Table 4: Comparative analysis of mean (SD) of sensory nerve conductions in upper and lower limb
SNL – Sensory Nerve Latency, SNAP – Sensory Nerve Action Potential, SNCV – Sensory Nerve Conduction Velocity, ms – milliseconds, mV – millivolts, m/s – meter per seconds, µV – micro-volts.
Parameter of nerve conduction studies (NCS) |
Upper and lower limit according to mean±2SD (95 percentile or 5 percentile) in our lab |
Mean±3SD Reference values for upper & lower limit of various parameters in a study by Chen S et al 2016 [4] |
Upper and lower limit according to mean±2SD (95 percentile or 5 percentile) in study by Shivji Z et al 2019 from Pakistan [6] |
Upper and lower limit according to mean±2SD (95 percentile or 5 percentile) in study by Fong SY et al 2016 from Malaysia [7] |
Median DML |
> 4 ms |
>4.5 ms |
> 3.8 ms |
> 4.1 ms |
Ulnar DML |
>3.5 ms |
>3.7 ms |
> 3.1 ms |
> 3.0 ms |
Peroneal DML |
>5.25 ms |
>6.5 ms |
> 4.5 ms |
> 4.2 ms |
Tibial DML |
>5.31 ms |
>6.1 ms |
> 5.0 |
> 4.1 ms |
Median CMAP |
<6.3 mV |
<4.1 mV |
< 6.2 mV |
< 7.4 mV |
Ulnar CMAP |
<6.2 mV |
<7.9 mV |
< 7.4 mV |
< 7.0 mV |
Peroneal CMAP |
<3.4 mV |
<1.3 mV |
< 3.2 mV |
< 3.0 mV |
Tibial CMAP |
<5.2 mV |
<4.4 mV |
< 5.7 mV |
< 7.5 mV |
% of fall in Proximal CMAP (Median) |
> 26% |
|
|
|
% of fall in Proximal CMAP (Ulnar) |
> 26% |
|
|
|
% of fall in Proximal CMAP (Peroneal) |
> 31% |
> 32% |
|
|
% of fall in Proximal CMAP (Tibial) |
> 59% |
> 71% |
|
|
Median MNCV |
<45.8 m/s |
<49 m/s |
< 51 m/s |
< 52 m/s |
Ulnar MNCV |
<47.97 m/s |
<52 m/s |
< 54 m/s |
< 53 m/s |
Peroneal MNCV |
<40.4 m/s |
<38 m/s |
< 45 m/s |
< 44 m/s |
Tibial MNCV |
<38.6 m/s |
<39 m/s |
< 42 m/s |
< 40 m/s |
Median FWL |
>29.03 ms |
|
> 29 ms |
|
Ulnar FWL |
>30.3 ms |
|
> 29 ms |
|
Peroneal FWL |
>52.6 ms |
|
> 54 ms |
|
Tibial FWL |
>54.3 ms |
|
> 50 ms |
|
Median PSNL |
>4.2 ms |
>3.3 ms |
> 3.5 ms |
|
Ulnar PSNL |
>3.8 ms |
>3.1 ms |
> 3.4 ms |
|
Sural PSNL |
>3.3 ms |
>3.6 ms |
> 3.8 ms |
|
Median SNAP |
<13.7 µV |
< 11 µV |
< 18 µV |
< 7 µV |
Ulnar SNAP |
<12.2 µV |
< 10 µV |
< 15 µV |
< 6 µV |
Sural SNAP |
<8.8 µV |
< 4 µV |
< 12 µV |
< 7 µV |
Median SNCV |
<44.2 m/s |
|
< 52 m/s |
< 47 m/s |
Ulnar SNCV |
<43.3 m/s |
|
< 53.3 m/s |
< 48 m/s |
Sural SNCV |
<54.5 m/s |
|
< 44 m/s |
< 41 m/s |
Table 5: Comparative upper and lower limit of normative values for different nerve conduction parameters in current and three other studies
DML- distal Motor Latency, CMAP – compound motor action potential, MNCV – motor nerve conduction velocity, FWL – f wave latency, PSNL –peak sensory nerve latency, SNAP – sensory nerve action potential, SNCV – sensory nerve conduction velocityParameters |
Percentage of patients found out of range according to the criteria of Chen S et al. [4] |
Percentage of patients found out of range according to the criteria of Shivji Z et al. |
Percentage of patients found out of range according to the criteria of Fong JY et al. |
Median MNCV |
72 (14.6%) had reading < 49 m/s |
133 (27%) had reading |
169 (34.3%) had reading |
Median PSNL |
308 (62.5%) had reading > 3.3 ms |
226 (45.8%) had reading > 3.5 ms |
|
Ulnar CMAP |
102 (20.7%) had reading < 7.9 mV |
67 (13.6%) had reading < 7.4 mV |
54 (11%) had reading |
Ulnar MNCV |
82 (16.6%) had reading |
121 (24.5%) had reading |
102 (20.7%) had reading |
Ulnar PSNL |
206 (41.8%) had reading > 3.1 ms |
94 (19%) had reading |
|
Table 6: Showing percentage of our patients lying out of reference values provided by other groups.
MNCV – Motor Nerve Conduction Velocity, PSNL – Peak Sensory Nerve Latency, CMAP – Compound Muscle Action Potential, ms – milliseconds, m/s – meter/second
Tables at a glance