Stimulation of peripheral nerves using a novel magnetic coil.

Abstract

Magnetic nerve stimulation (MNS) using a novel figure-8 magnetic coil was compared with conventional electric nerve stimulation (ENS) in normal subjects and in patients with disorders of the peripheral nervous system. In contrast to previously tested coils, the virtual cathode of the novel coil was independent of the geometrical or electric conditions of the stimulated tissue. Maximal compound muscle action potentials (CMAPs) were elicited by MNS in all motor nerves tested. The slopes of the recruitment curves of ENS were steeper than those of MNS, indicating a comparatively lower maximal stimulation intensity and a higher intensity resolution of the magnetic stimulator. In four patients with entrapment syndromes at the ulnar groove, motor conduction velocities and amplitudes were similar for MNS and ENS across the affected nerve segment. However, in two patients with chronic inflammatory demyelinating polyneuropathy (CIDP), CMAPs were slightly smaller following MNS. This new technique is a promising step toward the ultimate goal of replacing ENS with MNS.