Sensory study Lower limb

Medial plantar mixed nerve conduction study

Record the medial plantar mixed response at the medial ankle and stimulate the medial sole 14 cm distally.

01 · Placement

G1, G2, stimulation and ground landmarks

G1 active recording electrode

Place G1 slightly proximal and posterior to the medial malleolus over the tibial nerve in the tarsal-tunnel region.

G2 reference electrode

Place G2 3–4 cm proximal to G1 along the tibial nerve, preserving the proximal reference orientation for this orthodromic mixed study.

Distance · 3–4 cm proximal to G1

Stimulation site

Stimulate the medial plantar nerve on the medial sole 14 cm distal to G1, with the cathode directed toward the ankle.

Distance · 14 cm distal to G1

Ground region

Place the ground on the medial midfoot between the sole stimulation site and medial-ankle recording electrodes.

02 · Reference values

Measure	Reference limit	Basis
Mixed response amplitude	≥3 µV	AANEM educational reference
Conduction velocity	≥45 m/s	14 cm orthodromic technique
Distal peak latency	≤3.7 ms	14 cm orthodromic technique

03 · Technique

Fixed distance Medial sole stimulation to ankle G1: 14 cm

Sensitivity 5–10 µV/div

Filter 20 Hz–2 kHz

Sweep 1 ms/div

Temperature Maintain dorsal foot skin temperature >31°C

Ground Place the ground between the stimulating and recording electrodes

Primary evidence

Medial plantar mixed-nerve reference values for a 14 cm orthodromic technique.