scholarly journals Conduction block as an electrophysiological phenomenon: a review of the literature

2019 ◽  
Vol 9 (1) ◽  
pp. 12-23
Author(s):  
S. S. Nikitin ◽  
A. F. Murtazina ◽  
D. S. Druzhinin

Evaluation and interpretation of electrophysiological phenomena often plays an important role in the diagnosis of neuromuscular diseases. Motor nerve conduction block is a reduction of either amplitude or area of the compound motor action potential elicited by proximal to distal motor nerve stimulation. Today, the value of conduction block in the diagnosis of demyelinating and axonal neuropathies, as well as the diagnostic criteria for these disorders, are still under discussion.Objective of the review of the literature is to highlight the value of conduction block as an electrophysiological phenomenon in the light of clinical manifestations. There is no consensus in the literature which motor response parameters should be used as partial conduction block criteria. The diversity of pathogenic forms in which conduction block can be registered does not allow to consider the phenomenon as a sign of only demyelinating lesions, and the term conduction block should be considered as a pure electrophysiological phenomenon. Different pathophysiological mechanisms of conduction block formation should be studied separately within each nosology. Conduction block detection does not allow to specify a particular diagnosis, however, in conjunction with clinical and anamnestic data, it may be the main argument in the diagnosis of a number of peripheral nerves diseases.

2016 ◽  
pp. 257-291
Author(s):  
Lyell K. Jones ◽  
James C. Watson

A compound muscle action potential (CMAP) is the summated action potential recorded from muscle during a motor nerve conduction study (NCS). Motor NCSs with recording of CMAPs may be used for several purposes in assessing neuromuscular diseases, including providing objective measurements of the extent and localization of the cause of weakness; determining the underlying pathological abnormality, such as conduction block or slowing of conduction at a localized area of neurapractic injury; identifying the changes associated with Wallerian degeneration and regeneration in the motor nerve; and assisting (along with needle EMG) in distinguishing peripheral nerve disease from lower motor neuron disease, neuromuscular junction disease, and myopathies. This chapter will review the concepts and techniques of motor NCS and CMAP recording, will describe the technique and measurements, and will discuss the findings in various neuromuscular diseases.


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