Nerve conduction velocity measurements: improved accuracy using superimposed response waves.

A new procedure of serial motor nerve conduction velocity (NCV) measurements with the use of "superimposed response waves" technique (or double stimulus technique) was performed on 29 normal subjects. Six peripheral nerves were tested once a week for four to six weeks. A total of 760 NCV measurements were thus obtained to try to assess the magnitude of error in serial NCV testings. With the double stimulus technique employed, a significant reduction in variations of serial NCV measurements was found. The overall standard deviation of four to six consecutive NCV measurements in the 34 subjects was 1.3 meters per second with a coefficient of variation of 2.4%. These findings obtained with the double stimulus technique have proven to be approximately three times more accurate than results obtained by investigators who studied nerve conduction velocity measurement variation with single stimulus standard NCV testing techniques.