Brachial Plexus

Electro- diagnosis: NCV

Anatomy

Neuro-physiological Assessment
Stimulating point: Erbs point using surface or needle electrode. Recording electrode: placed over
Triceps for posterior cord Ulnar innervated muscle for lower trunk and medial cord

Latency compared with unaffected side Latency difference b/w right& left should not be excees 0.6 ms

Supraclavicular Nerve
Recording electrode: Needle electrode supraspinatus/ infraspinatus muscle Stimulating electrode: Supraclavical fossa Ground: on acromion Normal latency: 2.7 0.5 ms/3.3 0.5 ms

Long Thorasic Nerve

Recoding electrode:
G1 on 5/6 rib in mid axillary line G2 same rib at ant. Axillary live

Stimulation Electrode: Supraclavicular fossa Normal latency: 3.0 0.2 ms

Axillary Nerve
Recording Electrode:
G1 medial deltoid prominent G2 insertion of deltoid

Stimulation at Erbs point Ground: Acromian Normal:3.9 0.5 ms

Musculocutaneous Nerve
Recording Electrode:
G1 most prominent part of Bicep brachii G2 at insertion

Stimulation: at Erbs point Ground: Acromian Normal latency: 2.3 (1.7 2.9) ms, amplitude 6 (2.6 12.7) mV

Lateral antebrachial cutaneous nerve

Method: antidromic Recoding Electrode:
G1. 12 cm distal to stimulating point along a line connecting to radial styloid process G3 3 cm distal to G1

Stimulating: Lateral to insertion of biceps tension Velocity: 65 3.6 m/s Amplitude 24 7.2 micro volt

Medial antebrachial cutaneous nerve

Recording electrode: along a line connecting the point half way between median epicondyle and biceps to ulnar styloid process
G1. 7-8 cm distal to medial epichondyle G2 3 cm distal to G1

Stimulation: 4-5 cm proximal to medial epichondyle medial to Brachial artery. Velocity: 64.5 6.4 m/s Amplitude: 14.7 4.7 micro volt