Shock Artifact
Shock artifact is a common problem with smaller subjects because of short distances between the stimulator and recording electrodes. This may be particularly problematic with distal stimulation.
The ground electrode should be placed between the stimulating and recording electrodes, and, in infants, often a standard 6-mm silver disc or ring electrode can be placed around the wrist or ankle. Alternatively, the ground disc may be taped to the dorsal surface of the hand. Other approaches to minimize shock artifact in young children include the utilization of pumice paste to reduce skin impedance and permit suprathreshold stimulation with lower electrical currents, use of a minimal amount of conduction gel or cream, and rotation of the proximal anode in relation to the distal cathode.
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