orthodromic vs antidromic

[PMR 4 MSK]

When it comes to sensory studies - orthodromic vs antidromic - which do you do and when? Arm vs leg?

Most of the EMGers around me seem to only do orthodromic. I prefer antidromics in both arms and legs.

Any times you do both?

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[caedmon]

In our lab we use antidromics in the upper and lower extremities most of the time. Orthodromics may have more stimulus artifiact and lower amplitude repsonses and sometimes require needle recording.

In the upper limb we use orthodromics in the setting of mild carpal tunnel syndrome. For instance if there is no latency prolongation with median motor response. When this is the case we stimulate the median and ulnar in the palm and compare the relative latency to the ulnar recorded at the same distance.

In younger patients we will sometimes do an orthodromic medial plantar stimulation as we have found it may be more sensitive for neuropathy in those less than 55.

Otherwise we use mostly antis.

 

[njdevil]

antidromic sensory. I have seen orthodromics in a pure academic setting. otherwise for standard nerve conduction studies, orthodromic sensory studies will slow you down to acquire comparable data.