Needle EMG of abductor hallucis and peroneus tertius in normal subjects

Normal values for standard concentric-needle electromyography (EMG) of the abductor hallucis (AH) and peroneus tertius (PT) muscles have not been established to date, yet both are potentially useful muscles in the diagnosis of length-dependent peripheral nerve disorders. Forty-three normal asymptomatic subjects stratified by age underwent a standard set of nerve conduction studies and concentric-needle examination to exclude asymptomatic disease and develop normal values for the AH and the PT for various EMG parameters. Fibrillation potentials were observed in the AH in 21% of normal subjects (10% < 60 years old, 30% > 60 years old); 19% of subjects were unable to voluntarily activate the AH. All subjects could activate the PT regardless of age. No fibrillation potentials were observed in subjects < 60 years of age, whereas 9% of those older than 60 years had mild fibrillation potentials in the PT. The PT is a useful muscle in the evaluation of length-dependent peripheral neuropathy and other peripheral nerve disorders of the lower extremities, on the basis of ease of motor unit potential activation and analysis, and relative infrequency of fibrillation potentials in normal subjects.