Members Only Free CME! - 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. Methods: 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. Results: 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. Conclusions: 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.


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The AANEM designates this enduring material for a maximum of 2 AMA PRA Category 1 Credits ^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit expires 5/31/2023.

DISCLOSURE INFORMATION 
No one involved in the planning of this CME activity had any relevant financial relationships to disclose. Any conflicts have been resolved by the Journal in accordance with the Muscle & Nerve editorial process.

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Joao Leote, Msc; Pedro Pereira, MD; and Josep Valls-Sole, MD