title: Double peak sensory nerve action potentials to single stimuli in nerve conduction studies.
abstract: In humans, sensory nerve action potentials (SNAPs) can show 2 separate deflections, i.e., double peak potentials (DPp), which necessarily means that 1 peak is delayed with respect to the other. DPps may have various origins and be due to either physical or physiological properties.
  
  
  
  We review the nature of commonly encountered DPps in clinical practice, provide the most likely interpretations for their physiological origin, and assess their reproducibility and clinical utility.
  
  
  
  We classified the DPps into 3 categories: (1) simultaneous anodal and cathodal stimulation. (2) simultaneous recording from 2 different nerves at the same site, and (3) SNAP desynchronization.
  
  
  
  Although the recording of DPps is not a standardized neurophysiological method, their study brings interesting cues about the physiology of nerve stimulation and paves the way for clinical application of such an observation. Muscle Nerve 55: 619-625, 2017.
authors.affiliation: Neurosurgery Department, Hospital Garcia de Orta, Almada, Portugal.|Unitat d'Electromiografia, Servei de Neurologia, Hospital Clínic, Universitat de Barcelona, IDIBAPS (Institut d'Investigació Biomèdica August Pi i Sunyer), Barcelona, 08036, Spain.
authors.forename: Joao
authors.initials: J
authors.lastname: Leote
authors.affiliation: Neurology Department, Hospital Garcia de Orta, Almada, Portuga.
authors.forename: Pedro
authors.initials: P
authors.lastname: Pereira
authors.affiliation: Unitat d'Electromiografia, Servei de Neurologia, Hospital Clínic, Universitat de Barcelona, IDIBAPS (Institut d'Investigació Biomèdica August Pi i Sunyer), Barcelona, 08036, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Valls-Sole
mesh_terms: D000200:Action Potentials / Q000502:physiology*; D004558:Electric Stimulation / Q000379:methods; D004568:Electrodiagnosis / Q000379:methods*; D006801:Humans; D009431:Neural Conduction / Q000502:physiology*; D015203:Reproducibility of Results; D011984:Sensory Receptor Cells / Q000502:physiology*
keywords: anodal action potential; carpal tunnel syndrome; double peak potentials; longitudinal sliding; nerve conduction studies; sensory nerve action potentials