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Nerve membrane excitability testing

Published online by Cambridge University Press:  01 February 2008

W. J. Z’Graggen  and
H. Bostock
W. J. Z’Graggen*
Affiliation:
University of Bern, Department of Neurology, Inselspital, Bern, Switzerland
H. Bostock
Affiliation:
Institute of Neurology, Sobell Department of Neurophysiology, London, UK
*
Correspondence to: Werner J. Z’Graggen, Department of Neurology, Inselspital, University of Bern, CH-3010 Bern, Switzerland. E-mail: [email protected]; Tel: +41 31 632 21 11; Fax: +41 31 632 30 11
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Summary

Routine motor nerve conduction studies measure latencies, conduction velocities and amplitudes of compound action potentials. These measurements can be very useful in defining the pathology, while they provide little insight into the underlying disease mechanisms. Increasingly, the technique of ‘threshold tracking’ is being used in research and clinical studies on large myelinated axons. Nerve excitability testing is a non-invasive approach in investigating the pathophysiology of peripheral nerve disorders, which determines the electrical properties of the nerve membrane at the site of stimulation. We have found evidence that in patients with critical illness polyneuropathy peripheral nerves are depolarized. The correlations with serum factors suggest that this membrane depolarization is related to endoneurial hyperkalemia and/or hypoxia. While other mechanisms of depolarization may well be involved, the degree to which potential-sensitive nerve excitability indices are related to serum potassium and bicarbonate suggests that other factors, independent of potassium and acid–base balance, are likely to be of relatively minor significance.

Keywords

DEPOLARIZATIONAXONSNERVE CONDUCTIONMEASUREMENT AND MONITORINGPROGNOSIS
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue S42 , February 2008 , pp. 68 - 72
Copyright
Copyright © European Society of Anaesthesiology 2008

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