Aanem Practice Topic Electrodiagnostic Reference Values for Upper and Lower Limb Nerve Conduction Studies in Adult Populations

Introduction: To address the need for greater standardization within the field of electrodiagnostic medicine, the Normative Data Task Force (NDTF) was formed to identify nerve conduction studies (NCS) in the literature, evaluate them using consensus-based methodological criteria derived by the NDTF, and identify those suitable as a resource for NCS metrics. Methods: A comprehensive literature search was conducted of published peer-reviewed scientific articles for 11 routinely performed sensory and motor NCS from 1990 to 2012. Results: Over 7,500 articles were found. After review using consensus-based methodological criteria, only 1 study each met all quality criteria for 10 nerves. Conclusion: The NDTF selected only those studies that met all quality criteria and were considered suitable as a clinical resource for NCS metrics. The literature is, however, limited and these findings should be confirmed by larger, multicenter collaborative efforts. Muscle Nerve 54: 371–377, 2016 Electrodiagnostic (EDx) testing is used extensively to diagnose neuromuscular disorders but a universal standard for nerve conduction studies (NCS) is not available. Individual laboratories have been encouraged to use their own techniques for performing NCS and develop their own reference data, “despite inherent methodological and statistical challenges with this approach.” Other EDx physicians and laboratories have relied on reference data in textbooks or values passed along by academic teaching laboratories. However, many published studies do not meet contemporary statistical and methodological standards. Nerve conduction testing can be challenging and is dependent upon the skill of the EDx practitioners, instrumentation, and testing circumstances that have been discussed. The American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) formed the Normative Data Task Force (NDTF) to establish a set of evidencebased criteria to screen the peer-reviewed published literature. The NDTF’s report details the results of the review and selection of suitable articles regarding 11 routinely studied nerves.