Repetitive Nerve Stimulation Studies
Every attempt should be made to stabilize the extremity with an infant- or pediatric-size arm board. The author prefers to use a block electrode or surface cathode and anode electrodes taped over the nerve as opposed to a handheld stimulator.
This helps standardize each stimulation during a train of 5 stimuli at low or high rates of stimulation. In newborns, the author prefers to stimulate the median or ulnar nerve at the elbow to minimize shock artifact. Care should be taken to obtain a stable baseline between stimulations in a train. Decrements or increments in amplitude should be accompanied by similar decrements or increments in area. If no concomitant area changes occur, technical factors (changing baseline or changing temporal dispersion) may explain a decrement or increment in amplitude.
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