Meb9400 Eg-C

Examination Guide
EMG/EP
Measuring System
MEB-9400
MEB-9400A
MEB-9400K
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Contents 1
2
GENERAL HANDLING PRECAUTIONS.............................................................................. i
3
WARRANTY POLICY.......................................................................................................... ii
EMC RELATED CAUTION...................................................................................................iii 3-1
Conventions Used in this Manual and Instrument............................................................... v
Warnings, Cautions and Notes.................................................................................. v 3-2
Explanations of the Symbols in this Manual and Instrument.................................... vi
3-3
Section 1 General.................................................................................... 1.1 3-4
Introduction....................................................................................................................... 1.2
4
Installing Measurement Programs.................................................................................... 1.3
Important Safety Information............................................................................................ 1.4
4-1
4-2
Section 2 Electrode/Accessory Handling............................................. 2.1
EMG Needle Electrode..................................................................................................... 2.3 4-3
Type of Electrode.................................................................................................... 2.4
Electrode Attachment and Connection Procedure................................................. 2.5 4-4
Disinfection and Sterilization.................................................................................. 2.5

4-5
Disk Type Recording Electrode......................................................................................... 2.6
Type of Electrode.................................................................................................... 2.6
Electrode Placement on Head................................................................................ 2.6 5
Electrode Attachment and Connection Procedure................................................. 2.8
5-1
Handling after Use.................................................................................................. 2.8
Disinfection and Sterilization.................................................................................. 2.9
5-2
Skin Surface Stimulating Electrode................................................................................. 2.10
Type of Electrode . ............................................................................................... 2.10 5-3
Surface Stimulation Electrode.............................................................................. 2.11
Finger Electrode................................................................................................... 2.11 5-4
Somato Control Box.............................................................................................. 2.12
Grounding Electrode....................................................................................................... 2.14 5-5
Type of Electrode.................................................................................................. 2.14
Strap Type Ground Electrode Attachment and Connection Procedure................ 2.14 6
Disk Type Ground Electrode Attachment and Connection Procedure.................. 2.15
Handling after Use................................................................................................ 2.15 6-1
Disinfection and Sterilization................................................................................ 2.15
6-2
Collodion Electrode......................................................................................................... 2.16
6-3
Necessary Accessories........................................................................................ 2.17
Electrode Placement............................................................................................ 2.17
Electrode Attachment and Connection Procedure............................................... 2.17
Removing Collodion............................................................................................. 2.18
Disinfection and Sterilization................................................................................ 2.18
Headphones/Earphones................................................................................................. 2.19
Attachment and Connection Procedure................................................................ 2.19
Examination Guide MEB-9400 C.1

CONTENTS
Handling after Use................................................................................................ 2.19

ERG Contact Lens Electrode.......................................................................................... 2.20
Electrode Attachment and Connection Procedure............................................... 2.21
Disinfection........................................................................................................... 2.21
Sterilization........................................................................................................... 2.21
LED Goggles.................................................................................................................. 2.22
Attachment and Connection Procedure................................................................ 2.22
CRT Monitor for VEP Stimulation.................................................................................... 2.23
Connection........................................................................................................... 2.23
Thermistor Probe............................................................................................................ 2.24
Connection........................................................................................................... 2.24
Section 3 Somatosensory Evoked Potential..................................... 3.0.1

Section 3-1 Measurement – Basic.......................................................................... 3.1.1
Operation Flow............................................................................................................... 3.1.2
Entering the Patient Information.................................................................................... 3.1.4
Selecting the Examination Item..................................................................................... 3.1.5
Entering the Examination Information............................................................................ 3.1.6
Checking and Changing Measurement Settings............................................................ 3.1.7
Measurement Window Description.............................................................................. 3.1.11
Monitoring the Raw Waveforms (Monitor Window)............................................ 3.1.11
Starting Stimulation and Acquisition (Sweep Window)...................................... 3.1.12
Starting Averaging (Average Window)............................................................... 3.1.13
Stopping Monitoring, Acquisition or Averaging to Display, Measure or
Save a Waveform (Stop Window)...................................................................... 3.1.14
Section 3-2 Measurement – SEP/SSEP/ECSP....................................................... 3.2.1

General.......................................................................................................................... 3.2.2
Examination Programs........................................................................................ 3.2.2
Features............................................................................................................... 3.2.2
Preparation.................................................................................................................... 3.2.3
Electrode Attachment and Connection................................................................ 3.2.3
Checking Skin-Electrode Contact Impedance............................................................... 3.2.7
Measurement................................................................................................................. 3.2.8
Selecting the Program and Changing Measurement Settings............................. 3.2.8
Measurement Procedure..................................................................................... 3.2.8
Deleting Waveforms............................................................................................. 3.2.9
Saving Data on Disk............................................................................................ 3.2.9
Printing Data........................................................................................................ 3.2.9
Section 3-3 Measurement – ECG SSEP................................................................. 3.3.1

General.......................................................................................................................... 3.3.2
Features............................................................................................................... 3.3.2
Preparation.................................................................................................................... 3.3.3
C.2 Examination Guide MEB-9400

CONTENTS
Checking Skin-Electrode Contact Impedance............................................................... 3.3.5 1

Measurement................................................................................................................. 3.3.6
Selecting the Program and Changing Measurement Settings............................. 3.3.6 2
Deleting Waveforms............................................................................................. 3.3.8 3
Printing Data........................................................................................................ 3.3.8 3-1
3-2
Section 3-4 Calculation........................................................................................... 3.4.1
General.......................................................................................................................... 3.4.2 3-3
Marking.......................................................................................................................... 3.4.3
Manual Marking................................................................................................... 3.4.3 3-4
Setting a Mark at a Time........................................................................... 3.4.3
Moving a Mark..................................................................................................... 3.4.5 4
Deleting Marks..................................................................................................... 3.4.5
Deleting an Individual Mark....................................................................... 3.4.5 4-1
Deleting All Marks..................................................................................... 3.4.5
Measurement Table Window.......................................................................................... 3.4.6 4-2
To Open the Measurement Table Window........................................................... 3.4.7
To Close the Measurement Table Window........................................................... 3.4.7 4-3
Measurement Table Window Type I Description............................................................ 3.4.8

4-4
Evoked Measurement Table - Latency Window................................................... 3.4.8
Entering Normative Data........................................................................... 3.4.8
4-5
Annotating a Waveform............................................................................. 3.4.9
Evoked Measurement Table - Mark Pair Window................................................ 3.4.9
5
Selecting Measurement Items................................................................... 3.4.9
Setting Pairs............................................................................................ 3.4.10 5-1
Entering the Waveform Number.............................................................. 3.4.10
Evoked Measurement Table Window Type II Description............................................. 3.4.11 5-2
Evoked Measurement Table Window................................................................. 3.4.11
Annotating a Waveform........................................................................... 3.4.12 5-3
Selecting Measurement Items................................................................. 3.4.12
Setting Pairs............................................................................................ 3.4.12 5-4
SSEP Measurement Table Window................................................................... 3.4.13 5-5
Displaying Normative Range................................................................... 3.4.14
Creating the CSV File.............................................................................. 3.4.14 6
Saving Data on Disk.................................................................................................... 3.4.16
6-1
Condition Table Window............................................................................................... 3.4.16
Annotating a Waveform................................................................................................ 3.4.17
6-2
6-3
Section 4 Auditory Evoked Potential.................................................. 4.0.1
Operation Flow............................................................................................................... 4.1.2

CONTENTS
Settings for Each Examination Program.............................................................. 4.1.8

Stopping Monitoring, Acquisition or Averaging to Display, Measure or Save a
Waveform (Stop Window).................................................................................. 4.1.15
Section 4-2 Measurement – ABR............................................................................ 4.2.1

General.......................................................................................................................... 4.2.2
Features............................................................................................................... 4.2.2
Preparation.................................................................................................................... 4.2.3
Measurement................................................................................................................. 4.2.6
Automatic Measurement Procedure.................................................................... 4.2.7
Operations on the Stop Window.......................................................................... 4.2.8
Printing Data........................................................................................................ 4.2.8
Section 4-3 Measurement – MLR/SVR................................................................... 4.3.1

General.......................................................................................................................... 4.3.2
Features............................................................................................................... 4.3.2
Preparation.................................................................................................................... 4.3.3
Measurement................................................................................................................. 4.3.6
Printing Data........................................................................................................ 4.3.8
Section 4-4 Measurement – EcochG...................................................................... 4.4.1

General.......................................................................................................................... 4.4.2
Features............................................................................................................... 4.4.2
Preparation.................................................................................................................... 4.4.3
Derivation............................................................................................................ 4.4.4
Derivation from External Auditory Meatus................................................. 4.4.4
Derivation from Tympanic Membrane........................................................ 4.4.4
Derivation from Tympanic Promontory (Intratympanic Derivation)............ 4.4.5
Measurement . .............................................................................................................. 4.4.7

CONTENTS
Measurement Procedure..................................................................................... 4.4.7 1

Printing Data........................................................................................................ 4.4.9 3
AP and CM Classification.................................................................................... 4.4.9
3-1

3-2
General.......................................................................................................................... 4.5.3
Marking.......................................................................................................................... 4.5.4 3-3
Auto Marking During Acquisition......................................................................... 4.5.4
Marking After Acquisition..................................................................................... 4.5.4 3-4
Setting One Mark at a Time....................................................................... 4.5.4
Setting Multiple Marks Automatically According to the Settings on 4
the Labeling Page...................................................................................... 4.5.6
Moving a Mark..................................................................................................... 4.5.6 4-1
Deleting Marks..................................................................................................... 4.5.7
Measurement Table Windows........................................................................................ 4.5.8 4-3

4-4
To Close the Measurement Table Window........................................................... 4.5.9
Measurement Table Window Type I Description.......................................................... 4.5.10
4-5
For the MLR, SVR, EcochG Examination Program........................................... 4.5.10
Evoked Measurement Table - Latency Window................................................. 4.5.10
5
Entering Normative Data......................................................................... 4.5.10
Annotating a Waveform........................................................................... 4.5.11 5-1
Evoked Measurement Table - Mark Pair Window.............................................. 4.5.11
Selecting Measurement Items................................................................. 4.5.11 5-2
Setting Pairs............................................................................................ 4.5.12
Entering the Waveform Number.............................................................. 4.5.12 5-3
For the ABR Examination Program................................................................... 4.5.13
ABR Measure Window....................................................................................... 4.5.13 5-4
Setting Pairs............................................................................................ 4.5.14
Entering Normative Data......................................................................... 4.5.14 5-5
Annotating a Waveform........................................................................... 4.5.14
Measurement Table Window Type II Description......................................................... 4.5.15 6
For the MLR, SVR, EcochG Examination Program........................................... 4.5.15
6-1
6-2
Setting Pairs............................................................................................ 4.5.16
6-3
For the ABR Examination Program................................................................... 4.5.17
ABR Measurement Table Window..................................................................... 4.5.17
Routine.................................................................................................... 4.5.17
Laency-Interval-Amp. Table..................................................................... 4.5.17
V wave I-L Curve..................................................................................... 4.5.18
Latency-Interval-Amp. Table.................................................................... 4.5.18
V wave I-L Curve Graph.......................................................................... 4.5.19

CONTENTS
Diagnosis................................................................................................. 4.5.19
I-L Curve Window........................................................................................................ 4.5.20
Displaying the I-L Curve.......................................................................... 4.5.20
Creating a Normative Data File............................................................... 4.5.21
Section 5 Visual Evoked Potential...................................................... 5.0.1

Operation Flow............................................................................................................... 5.1.2
Stopping Monitoring, Acquisition or Averaging to Display, Measure or
Save a Waveform (Stop Window)...................................................................... 5.1.15
Section 5-2 Measurement – Pattern VEP/Goggle VEP/Flash VEP........................ 5.2.1

General.......................................................................................................................... 5.2.2
Programs............................................................................................................. 5.2.2
Features............................................................................................................... 5.2.2
Preparation.................................................................................................................... 5.2.4
Stimulator Connection......................................................................................... 5.2.4
Pattern/Stripe Reversal CRT Display Stimulation...................................... 5.2.4
LED Goggles Stimulation.......................................................................... 5.2.4
Stimulator SLS-3100................................................................................. 5.2.5
Visual Angle and Display Placement in Pattern-VEP Program........................... 5.2.5
Recommended Display Placement...................................................................... 5.2.6
Checking Skin-Electrode Contact Impedance............................................................. 5.2.10
Measurement............................................................................................................... 5.2.11
Selecting the Program and Changing Measurement Settings........................... 5.2.11
Measurement Procedure................................................................................... 5.2.11
Operations on the Stop Window........................................................................ 5.2.12
Deleting Waveforms........................................................................................... 5.2.13
Saving Data on Disk.......................................................................................... 5.2.13
Printing Data...................................................................................................... 5.2.13
Section 5-3 Measurement – ERG............................................................................ 5.3.1

General.......................................................................................................................... 5.3.2
Features............................................................................................................... 5.3.2
Preparation.................................................................................................................... 5.3.3
Stimulator Connection......................................................................................... 5.3.3

CONTENTS
Stimulator SLS-3100................................................................................. 5.3.3 1

Necessary Accessories/Unit................................................................................ 5.3.3
Electrode Attachment and Connection................................................................ 5.3.4 2
Measurement................................................................................................................. 5.3.6
Selecting the Program and Changing Measurement Settings............................. 5.3.6 3
Operations on the Stop Window.......................................................................... 5.3.7 3-1

3-2
Printing Data........................................................................................................ 5.3.7
3-3
Section 5-4 Measurement – EOG............................................................................ 5.4.1 3-4

General.......................................................................................................................... 5.4.2
Features............................................................................................................... 5.4.2 4
Preparation.................................................................................................................... 5.4.3
Necessary Unit.................................................................................................... 5.4.3 4-1
Checking Skin-Electrode Contact Impedance............................................................... 5.4.4 4-2
Measurement................................................................................................................. 5.4.5
4-3
4-4
Measuring Velocity Waveforms............................................................................ 5.4.6
4-5
Deleting Sites...................................................................................................... 5.4.7
5
Printing Data........................................................................................................ 5.4.7
5-1
General.......................................................................................................................... 5.5.2 5-2
Copying Waveforms to the Saved Waves Window........................................................ 5.5.3
Deleting All Waveforms and Measurement Results............................................. 5.5.4 5-3
Marking.......................................................................................................................... 5.5.5
Manual Marking................................................................................................... 5.5.5 5-4
Moving a Mark..................................................................................................... 5.5.7

5-5
Deleting Marks..................................................................................................... 5.5.7
Deleting an Individual Mark....................................................................... 5.5.7
6
Measurement Table Window.......................................................................................... 5.5.8
6-1
To Open the Evoked Measurement Table Window.............................................. 5.5.8
To Close the Evoked Measurement Table Window.............................................. 5.5.8 6-2
Evoked Measurement Table - Latency Window................................................... 5.5.9 6-3
Entering Normative Data........................................................................... 5.5.9
Evoked Measurement Table-Mark Pair Window................................................ 5.5.10
Setting Pairs............................................................................................ 5.5.11
Evoked Measurement Table Window Type II Description............................................. 5.5.12

CONTENTS

Setting Pairs............................................................................................ 5.5.13
Section 6 EMG...................................................................................... 6.0.1

Operation Flow............................................................................................................... 6.1.2
Starting Acquisition............................................................................................ 6.1.13
Section 6-2 Measurement – EMG........................................................................... 6.2.1

General.......................................................................................................................... 6.2.2
Preparation.................................................................................................................... 6.2.3
Measurement................................................................................................................. 6.2.4
Waveform Acquisition for EMG Measurement..................................................... 6.2.4
Operations on the Stop Window................................................................ 6.2.5
Waveform Acquisition for MUP Measurement..................................................... 6.2.6
Operations on the Stop Window................................................................ 6.2.8
Calling up Temporarily Saved Waveforms........................................................... 6.2.9
Selecting the Site No. to Display Waveforms on the Stop Window............ 6.2.9
Deleting Sites...................................................................................................... 6.2.9
Printing Data........................................................................................................ 6.2.9

General.......................................................................................................................... 6.3.2
Copying Waveforms to the Saved Waves Window......................................................... 6.3.3
Marking.......................................................................................................................... 6.3.5
Manual Marking................................................................................................... 6.3.5
Moving a Mark..................................................................................................... 6.3.7
Deleting Marks..................................................................................................... 6.3.7

CONTENTS
Deleting All Marks..................................................................................... 6.3.7 7

Measurement Table Window.......................................................................................... 6.3.8
To Open the EMG Measurement Table Window.................................................. 6.3.8 7-1
To Close the EMG Measurement Table Window.................................................. 6.3.8
Measurement Table Window Type I Description............................................................ 6.3.9 7-2
Measurement Table Window Type II Description......................................................... 6.3.11
Making an EMG Findings Window............................................................................... 6.3.13 7-3
Making an EMG Findings Summary Table Window........................................... 6.3.14

7-4
Calculation In the Manual MUP Window...................................................................... 6.3.15
Registering the Waveform....................................................................... 6.3.15
7-5
Deleting Registered Waveforms.............................................................. 6.3.15
7-6
Deleting All Waveforms and Calculation Results......................................................... 6.3.17
7-7
7-8
Section 7 Nerve Conduction Study.................................................... 7.0.1
Section 7-1 Nerve Conduction Study – Basic....................................................... 7.1.1 7-9
Operation Flow............................................................................................................... 7.1.2

7-10
7-11
7-12
Settings for Each Examination Program.............................................................. 7.1.8
MCS and SCS........................................................................................... 7.1.8 7-13
Rep. Stim................................................................................................. 7.1.11
F-wave..................................................................................................... 7.1.15 7-14
H-reflex.................................................................................................... 7.1.17
Blink......................................................................................................... 7.1.19 8
Section 7-2 Measurement – MCS............................................................................ 7.2.1

General.......................................................................................................................... 7.2.2
Features............................................................................................................... 7.2.2
Preparation.................................................................................................................... 7.2.3
Measurement................................................................................................................. 7.2.5
Entering the Nerve Name.................................................................................... 7.2.5
Printing Data........................................................................................................ 7.2.7

CONTENTS
Section 7-3 Calculation – MCS............................................................................... 7.3.1

General.......................................................................................................................... 7.3.2
Nerve Conduction Velocity Calculation.......................................................................... 7.3.3
Calculation with Cursors...................................................................................... 7.3.3
Calculation with Marks......................................................................................... 7.3.5
Marking.......................................................................................................................... 7.3.6
Marking After Acquisition..................................................................................... 7.3.6
Setting Multiple Marks Automatically According to the Settings on
Moving a Mark..................................................................................................... 7.3.8
Deleting Marks..................................................................................................... 7.3.9
Measurement Table Windows...................................................................................... 7.3.10
To Open the Measurement Table Window......................................................... 7.3.10
To Close the Measurement Table Window......................................................... 7.3.11
MCS Measurement Table Window..................................................................... 7.3.12
NCS Measurement Table Window..................................................................... 7.3.13
Entering Segment Waveforms................................................................. 7.3.13
Entering Skin Temperature...................................................................... 7.3.14
MCS Measurement Table Window..................................................................... 7.3.15
Entering the Site...................................................................................... 7.3.16
Changing the Waveform Order................................................................ 7.3.16
Creating the CSV File.............................................................................. 7.3.17
Section 7-4 Measurement – SCS............................................................................ 7.4.1

General.......................................................................................................................... 7.4.2
Features............................................................................................................... 7.4.2
Preparation.................................................................................................................... 7.4.3
SCS Orthodromic...................................................................................... 7.4.3
SCS Antidromic......................................................................................... 7.4.3
Measurement................................................................................................................. 7.4.7

CONTENTS
Printing Data...................................................................................................... 7.4.10 7
Section 7-5 Calculation – SCS................................................................................ 7.5.1 7-1
General.......................................................................................................................... 7.5.2
7-2
Nerve Conduction Velocity Calculation.......................................................................... 7.5.3
7-3
Marking.......................................................................................................................... 7.5.6 7-4
Automatically Setting Multiple Marks According to the Settings on 7-6
Moving a Mark..................................................................................................... 7.5.8 7-7
Deleting Marks..................................................................................................... 7.5.9
7-9
7-10
7-11
SCS Measurement Table Window..................................................................... 7.5.12
7-12
NCS Measurement Table Window..................................................................... 7.5.13
Entering Segment Waveforms................................................................. 7.5.13 7-13
Entering Skin Temperature...................................................................... 7.5.14 7-14
SCS Measurement Table Window..................................................................... 7.5.15 8
Entering the Site...................................................................................... 7.5.16
Changing the Waveform Order................................................................ 7.5.16
Creating the CSV File.............................................................................. 7.5.17
Section 7-6 Measurement – Rep.Stim.................................................................... 7.6.1

General.......................................................................................................................... 7.6.2
Features............................................................................................................... 7.6.2
Preparation.................................................................................................................... 7.6.3
Measurement................................................................................................................. 7.6.5
Automatic Measurement Procedure.................................................................... 7.6.7
Calling Up Waveforms and Data from Memory................................................... 7.6.7

CONTENTS

Printing Data........................................................................................................ 7.6.8
Section 7-7 Calculation – Rep.Stim........................................................................ 7.7.1

General.......................................................................................................................... 7.7.2
Marking.......................................................................................................................... 7.7.3
Marking After Acquisition..................................................................................... 7.7.3
Moving a Mark..................................................................................................... 7.7.5
Deleting Marks..................................................................................................... 7.7.6
Measurement Table Windows........................................................................................ 7.7.7
To Close the Measurement Table Window........................................................... 7.7.7
Rep.stim Measurement Table Window................................................................. 7.7.8
Annotating a Waveform............................................................................. 7.7.9
Entering the Stim. Site and Recording Site............................................... 7.7.9
Selecting the Reference Waveform for Decrement Ratio Calculation
(Selecting the Reference Stim. No.).......................................................... 7.7.9
Selecting the Channel............................................................................... 7.7.9
Rep.stim Measurement Table Window............................................................... 7.7.10
Selecting the Rec. No.............................................................................. 7.7.11
Entering the Stim. No............................................................................... 7.7.11
Summary Graph...................................................................................... 7.7.11
Displaying the Rep. stim Summary Window................................................................ 7.7.12
To Open and Close the Rep.stim Summary Window......................................... 7.7.12
Description of the Rep. stim Summary Window................................................. 7.7.12
Section 7-8 Measurement – F-wave....................................................................... 7.8.1

General.......................................................................................................................... 7.8.2
Features............................................................................................................... 7.8.2
Preparation.................................................................................................................... 7.8.3
Measurement................................................................................................................. 7.8.5
Calling Up Waveforms and Data from Memory................................................... 7.8.7

CONTENTS

Printing Data........................................................................................................ 7.8.8 7-1
Section 7-9 Calculation – F-wave........................................................................... 7.9.1 7-2
General.......................................................................................................................... 7.9.2
7-3
F-wave Conduction Velocity Measurement.................................................................... 7.9.3
7-4
Marking.......................................................................................................................... 7.9.6
7-5
Setting Multiple Marks Automatically According to the Settings on 7-7
Moving a Mark..................................................................................................... 7.9.8 7-8
Deleting Marks..................................................................................................... 7.9.9
F-wave Measurement Table Window........................................................................... 7.9.10 7-10
To Close the Measurement Table Window......................................................... 7.9.10 7-11

7-12
F-wave Measurement Table Window................................................................. 7.9.11
7-13
Entering the Stim. Site and Recording Site............................................. 7.9.12
Entering the Distance (mm)..................................................................... 7.9.12
7-14
Entering the Amplitude Threshold........................................................... 7.9.12
F-wave Histogram Window Description............................................................. 7.9.13
8
F-wave Measurement Table Window................................................................. 7.9.14
Entering the Stim. Site and Recording Site............................................. 7.9.15
F-wave Table Window........................................................................................ 7.9.15
Entering the Amplitude Threshold........................................................... 7.9.16
F-wave Sensitivity Change.......................................................................................... 7.9.17
Section 7-10 Measurement – H-reflex.................................................................... 7.10.1

General........................................................................................................................ 7.10.2
Features............................................................................................................. 7.10.2
Preparation.................................................................................................................. 7.10.3
Electrode Attachment and Connection.............................................................. 7.10.3
Measurement............................................................................................................... 7.10.5
Entering the Nerve Name.................................................................................. 7.10.5

CONTENTS

Copying the Acquired Waveforms to the Stop Window...................................... 7.10.7
Copying Procedure.................................................................................. 7.10.7
Printing Data...................................................................................................... 7.10.8
Section 7-11 Calculation – H-reflex........................................................................ 7.11.1

General........................................................................................................................ 7.11.2
Marking........................................................................................................................ 7.11.3
Auto Marking During Acquisition....................................................................... 7.11.3
Marking After Acquisition................................................................................... 7.11.3
Setting One Mark at a Time..................................................................... 7.11.3
the Labeling Page.................................................................................... 7.11.5
Moving a Mark................................................................................................... 7.11.5
Deleting Marks................................................................................................... 7.11.6
Deleting an Individual Mark..................................................................... 7.11.6
Deleting All Marks................................................................................... 7.11.6
H-reflex Measurement Table Window.......................................................................... 7.11.7
H-reflex Measurement Table Window................................................................ 7.11.9
Annotating a Waveform......................................................................... 7.11.10
Entering the Stim. Site and Recording Site........................................... 7.11.10
Measurement Table Window Type II Description....................................................... 7.11.11
H-reflex Measurement Table Window.............................................................. 7.11.11
Annotating a Waveform......................................................................... 7.11.12
Intensity Amplitude Graph..................................................................... 7.11.12
Saving Data on Disk.................................................................................................. 7.11.13
Condition Table Window............................................................................................. 7.11.13
Annotating a Waveform.............................................................................................. 7.11.14
Section 7-12 Measurement – Blink......................................................................... 7.12.1

General........................................................................................................................ 7.12.2
Features............................................................................................................. 7.12.2
Preparation.................................................................................................................. 7.12.3
Electrode Attachment and Connection.............................................................. 7.12.3
Measurement............................................................................................................... 7.12.5
Entering the Nerve Name.................................................................................. 7.12.5
Printing Data...................................................................................................... 7.12.7

CONTENTS
Section 7-13 Calculation – Blink............................................................................. 7.13.1 7

General........................................................................................................................ 7.13.2
Marking........................................................................................................................ 7.13.3 7-1
Marking After Acquisition................................................................................... 7.13.3

7-2
Moving a Mark................................................................................................... 7.13.5
Deleting Marks................................................................................................... 7.13.5
7-3
Deleting an Individual Mark..................................................................... 7.13.5
Deleting All Marks................................................................................... 7.13.5
7-4
To Open the Measurement Table Window......................................................... 7.13.6 7-5
Measurement Table Window Type I Description.......................................................... 7.13.8 7-6
Evoked Measurement Table - Latency Window................................................. 7.13.8
Entering Normative Data......................................................................... 7.13.8 7-7
Evoked Measurement Table - Mark Pair Window.............................................. 7.13.9 7-8
Setting Pairs.......................................................................................... 7.13.10 7-9
Entering the Waveform Number............................................................ 7.13.10
Measurement Table Window Type II Description....................................................... 7.13.11 7-10
Blink Measurement Table Window................................................................... 7.13.11

7-11
Marking for Calculating with the Blink Measurement Table Window...... 7.13.12
Entering the Stage................................................................................. 7.13.12
7-12
Rectified Average Wave......................................................................... 7.13.12
Displaying the Normative Range........................................................... 7.13.13
7-13
Creating the CSV File............................................................................ 7.13.13
Saving Data on Disk.................................................................................................. 7.13.15 7-14
Condition Table Window............................................................................................. 7.13.15
Annotating a Waveform.............................................................................................. 7.13.16 8
Section 7-14 NCS (Nerve Conduction Studies).................................................... 7.14.1

General........................................................................................................................ 7.14.2
Setup................................................................................................................. 7.14.2
Operation Procedure................................................................................................... 7.14.3
Settings for Each Examination Program............................................................ 7.14.3
Operation Procedure......................................................................................... 7.14.8
When the Examination Order is Set........................................................ 7.14.8
When the Examination Order is Not Set................................................. 7.14.9
Starting Measurement .......................................................................... 7.14.10
Marking.................................................................................................. 7.14.11
Changing the Examination Type............................................................ 7.14.11
Changing the Examination Side............................................................ 7.14.11
Selecting Other Nerve........................................................................... 7.14.11
MCS/SCS Measurement Table Window.......................................................... 7.14.12
F-wave Measurement Table Window............................................................... 7.14.15
Saving Data on Disk........................................................................................ 7.14.17
Printing a Report............................................................................................. 7.14.17

CONTENTS
Section 8 Troubleshooting..................................................................... 8.1

Waveform Acquisition....................................................................................................... 8.3
Acquiring Clear Waveforms.............................................................................................. 8.4
AC Interference....................................................................................................... 8.4
Spike Noise............................................................................................................ 8.5
Other Noise............................................................................................................ 8.6

GENERAL HANDLING PRECAUTIONS
This device is intended for use only by qualified medical personnel.

Use only Nihon Kohden approved products with this device. Use of non-approved products
or in a non-approved manner may affect the performance specifications of the device. This
includes, but is not limited to, batteries, recording paper, pens, extension cables, electrode
leads, input boxes and AC power.
Please read these precautions thoroughly before attempting to operate the instrument.
1. To safely and effectively use the instrument, its operation must be fully understood.
2. When installing or storing the instrument, take the following precautions:

(1) Avoid moisture or contact with water, dust, extreme atmospheric pressure, excessive humidity and temperatures,
poorly ventilated areas, and saline or sulphuric air.
(2) Place the instrument on an even, level floor. Avoid vibration and mechanical shock, even during transport.
(3) Avoid placing in an area where chemicals are stored or where there is danger of gas leakage.
(4) The power line source to be applied to the instrument must correspond in frequency and voltage to product
specifications, and have sufficient current capacity.
(5) Choose a room where a proper grounding facility is available.
3. Before Operation
(1) Check that the instrument is in perfect operating order.
(2) Check that the instrument is grounded properly.
(3) Check that all cords are connected properly.
(4) Pay extra attention when the instrument is in combination with other instruments to avoid misdiagnosis or other
problems.
(5) All circuitry used for direct patient connection must be doubly checked.
(6) Check that battery level is acceptable and battery condition is good when using battery-operated models.
4. During Operation
(1) Both the instrument and the patient must receive continual, careful attention.
(2) Turn power off or remove electrodes and/or transducers when necessary to assure the patient’s safety.
(3) Avoid direct contact between the instrument housing and the patient.
5. To Shutdown After Use

(1) Turn power off with all controls returned to their original positions.
(2) Remove the cords gently; do not use force to remove them.
(3) Clean the instrument together with all accessories for their next use.
6. The instrument must receive expert, professional attention for maintenance and repairs. When the instrument
is not functioning properly, it should be clearly marked to avoid operation while it is out of order.
7. The instrument must not be altered or modified in any way.
8. Maintenance and Inspection

(1) The instrument and parts must undergo regular maintenance inspection at least every 6 months.
(2) If stored for extended periods without being used, make sure prior to operation that the instrument is in perfect
operating condition.
Examination Guide MEB-9400

(3) Technical information such as parts list, descriptions, calibration instructions or other information is available for
qualified user technical personnel upon request from your Nihon Kohden representative.
9. When the instrument is used with an electrosurgical instrument, pay careful attention to the application and/or
location of electrodes and/or transducers to avoid possible burn to the patient.
10. When the instrument is used with a defibrillator, make sure that the instrument is protected against defibrillator
discharge. If not, remove patient cables and/or transducers from the instrument to avoid possible damage.
WARRANTY POLICY
Nihon Kohden Corporation (NKC) shall warrant its products against all defects in materials and workmanship for one year
from the date of delivery. However, consumable materials such as recording paper, ink, stylus and battery are excluded
from the warranty.
NKC or its authorized agents will repair or replace any products which prove to be defective during the warranty period,
provided these products are used as prescribed by the operating instructions given in the operator’s and service manuals.
No other party is authorized to make any warranty or assume liability for NKC’s products. NKC will not recognize any
other warranty, either implied or in writing. In addition, service, technical modification or any other product change
performed by someone other than NKC or its authorized agents without prior consent of NKC may be cause for voiding
this warranty.
Defective products or parts must be returned to NKC or its authorized agents, along with an explanation of the failure.
Shipping costs must be pre-paid.
This warranty does not apply to products that have been modified, disassembled, reinstalled or repaired without Nihon
Kohden approval or which have been subjected to neglect or accident, damage due to accident, fire, lightning, vandalism,
water or other casualty, improper installation or application, or on which the original identification marks have been
removed.
In the USA and Canada other warranty policies may apply.
CAUTION
United States law restricts this product to sale by or on the order of a physician.
ii Examination Guide MEB-9400

EMC RELATED CAUTION
This equipment and/or system complies with IEC 60601-1-2 International Standard for electromagnetic
compatibility for medical electrical equipment and/or system. However, an electromagnetic environment
that exceeds the limits or levels stipulated in IEC 60601-1-2, can cause harmful interference to the
equipment and/or system or cause the equipment and/or system to fail to perform its intended function or
degrade its intended performance. Therefore, during the operation of the equipment and/or system, if there
is any undesired deviation from its intended operational performance, you must avoid, identify and resolve
the adverse electromagnetic effect before continuing to use the equipment and/or system.
The following describes some common interference sources and remedial actions:
1. Strong electromagnetic interference from a nearby emitter source such as an authorized radio station
or cellular phone:
Install the equipment and/or system at another location. Keep the emitter source such as cellular
phone away from the equipment and/or system, or turn off the cellular phone.
2. Radio-frequency interference from other equipment through the AC power supply of the equipment
and/or system:
Identify the cause of this interference and if possible remove this interference source. If this is not
possible, use a different power supply.
3. Effect of direct or indirect electrostatic discharge:

Make sure all users and patients in contact with the equipment and/or system are free from direct or
indirect electrostatic energy before using it. A humid room can help lessen this problem.
4. Electromagnetic interference with any radio wave receiver such as radio or television:
If the equipment and/or system interferes with any radio wave receiver, locate the equipment and/or
system as far as possible from the radio wave receiver.
5. Interference of lightning:
When lightning occurs near the location where the equipment and/or system is installed, it may induce
an excessive voltage in the equipment and/or system. In such a case, disconnect the AC power cord
from the equipment and/or system and operate the equipment and/or system by battery power, or use
an uninterruptible power supply.
6. Use with other equipment:

When the equipment and/or system is adjacent to or stacked with other equipment, the equipment
and/or system may affect the other equipment. Before use, check that the equipment and/or system
operates normally with the other equipment.
7. Use of unspecified accessory, transducer and/or cable:

When an unspecified accessory, transducer and/or cable is connected to this equipment and/or
system, it may cause increased electromagnetic emission or decreased electromagnetic immunity.
The specified configuration of this equipment and/or system complies with the electromagnetic
requirements with the specified configuration. Only use this equipment and/or system with the specified
configuration.
Examination Guide MEB-9400 iii

Caution - continued
8. Use of unspecified configuration:
When the equipment and/or system is used with the unspecified system configuration different than
the configuration of EMC testing, it may cause increased electromagnetic emission or decreased
electromagnetic immunity. Only use this equipment and/or system with the specified configuration.
9. Measurement with excessive sensitivity:

The equipment and/or system is designed to measure bioelectrical signals with a specified sensitivity. If
the equipment and/or system is used with excessive sensitivity, artifact may appear by electromagnetic
interference and this may cause mis-diagnosis. When unexpected artifact appears, inspect the
surrounding electromagnetic conditions and remove this artifact source.
If the above suggested remedial actions do not solve the problem, consult your Nihon Kohden
representative for additional suggestions.
For EMC compliance, refer to “Specification - Electromagnetic Compatibility” in the Reference section of the operator’s
manual.
The CE mark is a protected conformity mark of the European Community. Products with the CE mark comply
with the requirements of the Medical Device Directive 93/42/EEC.
The CE mark is only applied to the MEB-9400K EMG/EP Measuring System.
This equipment complies with International Standard IEC 60601-1-2: 2001.
iv Examination Guide MEB-9400

Conventions Used in this Manual and Instrument
Warnings, Cautions and Notes

Warnings, cautions and notes are used in this manual to alert or signal the reader to specific information.
WARNING
A warning alerts the user to the possible injury or death associated with the use or misuse of the
instrument.
CAUTION
A caution alerts the user to possible injury or problems with the instrument associated with its use or
misuse such as instrument malfunction, instrument failure, damage to the instrument, or damage to other
property.
NOTE
A note provides specific information, in the form of recommendations, prerequirements, alternative methods or
supplemental information.
Examination Guide MEB-9400

Explanations of the Symbols in this Manual and Instrument
The following symbols found in this manual/instrument bear the respective descriptions as given.
Main unit
Symbol Description Symbol Description
Alternating current Equipotential terminal
Loudspeaker Protective earth
Intensity control Type BF applied part
Electric stimulation Fuse
Attention, consult operator’s

Headphone connector
manual
Goggles Serial number
Pattern reversal Date of manufacture
USB connector Foot switch
Power on Power off
The CE mark is a protected

Electrode junction box conformity mark of the European
Community. Products marked
with this symbol comply with
the requirements of the Medical
Input/output connector Device Directive 93/42/EEC.
(DC-940BK only)
Products marked with this
symbol comply with the
European WEEE directive
2002/96/EEC and require
separate waste collection. For
Nihon Kohden products marked
with this symbol, contact your
Nihon Kohden representative for
disposal. (DC-940BK only)
vi Examination Guide MEB-9400

Electrode junction box
The CE mark is a protected

Type BF applied part conformity mark of the European
Community. Products marked
with this symbol comply with
Serial number the requirements of the Medical
Device Directive 93/42/EEC.
Products marked with this

Attention, consult operator’s symbol comply with the
manual European WEEE directive
2002/96/EEC and require
separate waste collection. For
Nihon Kohden products marked
Date of manufacture with this symbol, contact your
Nihon Kohden representative for
disposal.
Somato control box
Electric stimulation Date of manufacture
Plus: positive polarity Serial number
Minus: negative polarity
On screen
Warning query that displays a

Display of list box
warning or caution for operation.
Warning message that displays a

Scrolling of data, list and others
warning or caution for operation.
Window maximize/resize
Check box Maximize Resize Minimize minimize button
Option button Close button
Examination Guide MEB-9400 vii

Foot switch
Protected against vertically

Serial number
IPX 1 falling water drops
viii Examination Guide MEB-9400

Section 1 General 1
Introduction........................................................................................................................................................... 1.2
Installing Measurement Programs........................................................................................................................ 1.3
Important Safety Information................................................................................................................................ 1.4
Examination Guide MEB-9400 1.1

1. GENERAL
Introduction
The Neuropack MEB-9400 Series EMG/EP Measuring System (hereafter

referred to as the system) is designed to measure and average EMG, electric/
auditory/visual evoked potential and nerve conduction. The following
measurement programs are standard.
Somatosensory Evoked Potential Program

• Somatosensory evoked potential (SEP) measurement
• Short-latency somatosensory evoked potential (SSEP) measurement
• ECG triggered SSEP (ECG-SSEP) measurement
• Evoked spinal cord potential (ESCP) measurement
• Customizable somatosensory protocol (ELECTRIC)
Auditory Evoked Potential Program

• Auditory brainstem response (ABR) measurement
• Middle latency response (MLR) measurement
• Slow vertex response (SVR) measurement
• Electrocochleogram (ECOCHG) measurement
• Customizable auditory protocol (AUDITORY)
Visual Evoked Potential Program

• Pattern reversal - Visual evoked potential (Pattern-VEP) measurement
• Flash LED goggles - Visual evoked potential (LED-VEP) measurement
• External stimulator - Visual evoked potential (EXT-VEP) measurement
• Electroretinogram (ERG) measurement
• Electrooculogram (EOG) measurement
• Customizable visual control (VISUAL)
EMG (electromyogram) Program
Nerve Conduction Study Program

• Motor nerve conduction study (MCS)
• Sensory nerve conduction study (SCS)
• Repetitive stimulation (REP. STIM)
• F-wave measurement (F-WAVE)
• Monosynaptic reflex H-wave (H-REFLEX) measurement
• Polysynaptic reflex (orbicularis oculi muscle reflex) measurement (BLINK)
• Nerve conduction studies (NCS)
Refer to the MEB-9400 operator’s manual for basic operation, measurement

and important safety information. In this operator’s manual, electrode lead
connections and operation explanations use the JB-944BK Electrode Junction
Box as an example.
1.2 Examination Guide MEB-9400

1. GENERAL
1
Installing Measurement Programs
For the installation procedure, refer to the MEB-9400 operator’s manual.

1. GENERAL
Important Safety Information
General
WARNING WARNING
Never use the system in the presence of any Never use the system in a hyperbaric oxygen
flammable anesthetic gas or high concentration chamber. Failure to follow this warning may cause
oxygen atmosphere. Failure to follow this warning explosion or fire.
may cause explosion or fire.
WARNING WARNING
Do not diagnose patients based on only the data When using an electrically controlled
from this instrument. Overall judgement must be neurovascular intervention device such as an
performed by a physician who understands the endovascular coil, follow the instructions of the
features, limitations and characteristics of the device’s manual.
instrument by reading this operator’s manual
thoroughly and by reading the biomedical signals
acquired by other instruments.
MRI examination
WARNING WARNING
When performing MRI test, remove all electrodes Never use this system in an MRI examination
and transducers from the patient which are room. The system may not operate properly due
connected to this system. Failure to follow this to high frequency magnetic noise from the MRI.
warning may cause skin burn on the patient. For
details, refer to the MRI manual.
Using with an electrical surgical unit (ESU)
WARNING WARNING
Do not use the system near an ESU. Noise from When the system is used with an electrosurgical
the ESU may cause the system to malfunction. unit (ESU), firmly attach the entire area of the
ESU return plate. Otherwise, the current from the
ESU flows into the electrodes of the system,
causing electrical burn where the electrodes are
attached. For details, refer to the ESU manual.

1. GENERAL
1
WARNING WARNING
While using an ESU, needle electrodes, silver When using an ESU, do the following. Otherwise,
ball electrodes and intracranial electrodes must current from the ESU flows into the electrodes
not be used for monitoring unless no other and causes skin burn.
alternatives are available. If needle electrodes, • Ensure that there is enough distance between
silver ball electrodes and intracranial electrodes the electrodes and the ESU tip or return plate.
are used, whenever possible, disconnect • Ensure that no electrodes are attached near
electrodes from the electrode junction box while the path for high frequency current between the
using the ESU. Otherwise, current from the ESU ESU tip and return plate.
might cause skin burn where the electrodes are • If there is not enough distance between the
attached. electrodes and the ESU tip, return plate or
path for high frequency current, disconnect the
electrodes and breakout box connector from
the electrode junction box while using the ESU.
• During long term monitoring, periodically check
that the electrodes are attached properly.
Using with a shortwave or microwave therapy equipment
WARNING
Operation in close proximity (for example 1 m) to
shortwave or microwave therapy equipment may
cause instability in the ELECTRICAL
STIMULATOR output.
Using with a defibrillator
WARNING WARNING
Before defibrillation, all persons must keep clear Before defibrillation, remove everything including
of the bed and must not touch the patient or any electrodes and patches from the patient s chest.
equipment or cable connected to the patient. If the defibrillator paddle contacts an object on
Failure to follow this warning may cause electrical the patient’s chest, the discharged energy may
shock or injury. be insufficient and cause skin burn.
WARNING
Before defibrillation, remove from the patient all
electrodes, probes and transducers from
connectors that do not have a or mark.
Otherwise, the operator may receive electrical
shock and the connected instrument may be
damaged.

1. GENERAL
Installation
WARNING WARNING
Only use a 3-prong power cord. Using other Equipotential grounding is required for electrical
power cords may result in electrical shock or safety. Consult with a qualified biomedical
injury to the patient and operator. engineer.
WARNING WARNING
Before connecting or disconnecting instruments, When connecting external equipment to this
make sure that each instrument is turned off and system, ensure that the external equipment
the power cord is disconnected from the AC complies with the IEC 60601-1 safety standard
socket. Otherwise, the patient or operator may for medical equipment and CISPR11 Second
receive electrical shock or injury. Edition 1990-1999 Group 1 and Class B
standard, or the equivalent. When the external
equipment does not comply with the IEC 60601-1
safety standard, use a locally available medical
use isolation transformer unit between the
external equipment and the AC outlet.
WARNING WARNING
When connecting an external instrument to the Install all network devices, including printer and
connectors marked with of the system, the hubs, outside the patient environment (IEC
external instrument and system must be 60601-1-1). If they are installed inside the patient
connected according to the IEC 60601-1-1 environment, the patient or operator may receive
“Medical electrical equipment - Part 1-1: General electrical shock or injury. For installation, contact
requirements for safety - Collateral standard: your Nihon Kohden representative.
Safety requirements for medical electrical
systems”. Failure to follow this warning may
cause electrical shock to the patient and operator.
WARNING WARNING
Do not use a damaged network cable. The patient Connect the system to network as specified.
or operator may receive electrical shock when the Otherwise the patient and operator may receive
damaged part is touched. electrical shock or injury. To connect the network,
contact your Nihon Kohden representative.
CAUTION CAUTION
Use the YS-004A9 tool set for cart assembly. Select an installation location where patient
information cannot be seen or accessed by
unauthorized personnel.

1. GENERAL
1
CAUTION CAUTION
Do not install the system near equipment with a Do not install the system where it will be exposed
high power consumption, such as large X-ray to water or chemical solutions. Avoid direct
equipment. sprinkling, spray or moist air from the nebulizer or
humidifier. These cause malfunction and shorten
the life of the system.
CAUTION CAUTION
Do not install the system near a power line, Select a room with no excessive noise, vibration,
dynamo or motor which has electromagnetic sunlight, high humidity or water splashes.
induction.
CAUTION CAUTION
Make sure that there is no influence from a Select a room with a 3-prong outlet with a ground
cellular phone. third contact.
CAUTION CAUTION
Avoid locations where the system may receive When the external noise is too large, install the
strong electromagnetic interference and high- system in a shielded room.
frequency electric interference such as radio or
TV stations, cellular phones or mobile two-way
radios. Otherwise, the display may flicker or the
displayed waveform trace may be thicker.
CAUTION CAUTION
A sudden loss of power or extreme power surge Only install the specified software in the system.
can damage data and the computer. To assure an Unspecified software may cause the system to
uninterrupted power supply, use an malfunction. Nihon Kohden has no responsibility
uninterruptable power supply (UPS). for any problem caused by unspecified software.
CAUTION CAUTION
Do not delete any files in the hard disk. The Be careful not to pinch your fingers between the
system may not start. PC unit, main unit, isolation unit, printer and cart.
CAUTION CAUTION
Use only the KD-019A cart or KD-026A cart for When moving the system, select a flat path and
this system. If the specified cart is not available move the system carefully to prevent it from
and you must use another cart, use a cart that tipping over or components falling off.
complies with IEC 60601-1. Otherwise, the cart
may tip over and the cart and system
components may break. Also secure the cables
of the instrument to ensure electrical safety and
to prevent components from falling off or cable
disconnection.

1. GENERAL
CAUTION CAUTION
• Do not move the cart with the casters locked. Do not carelessly touch connectors on the
The cart may tip over. system components. The system may
• When moving the cart, hold the handle of malfunction due to electrostatic energy. Everyone
the cart. Never hold the arm for the electrode who uses this system must be trained in the
junction box. prevention of electrostatic discharge (ESD).
CAUTION
Do not connect unspecified devices such as USB
memory to the USB connectors of this instrument
because the device may have a computer virus.
Operation
Unused connectors on the electrode junction box
WARNING
During measurement, do not touch any connector
that an electrode is not connected to. If an
instrument that is connected to the patient is
faulty, the patient and operator may get electrical
shock.
Using a cup containing water
WARNING
Do not put a water cup where it can spill on the
system. It may cause electrical shock to the
patient and operator and cause system
malfunction.
Using a needle electrode
WARNING WARNING
Do not use a needle electrode for electric When the needle electrode is used on a
stimulation. Failure to follow this warning injures potentially contagious patient, dispose of the
the patient because the needle electrode is needle electrode by following your facility’s
damaged by electrolyzation inside the body. regulations or local laws for disposing of the
infectious medical waste.
WARNING
To prevent infection, autoclave the needle
electrodes before and after use.

1. GENERAL
Applying stimulation to the patient 1
WARNING WARNING
For patients with the following conditions, all For visual stimulation always prepare mouth
stimulation (activations) must be applied under gags, tongue depressors and gauze sponges to
the supervision of the physician in charge. prevent the patient from biting his tongue or
• Patients with a history of epilepsy, cortical injuring himself during testing. Visual stimulation
lesions, convexity skull defects, raised may induce seizure activity.
intracranial pressure, neurological or psychiatric
disorders or cardiac disease
WARNING
• Patients with a history of cerebral aneurysm
Do not apply photic stimulation continuously for
treatment using surgical devices such as
more than 5 minutes in any mode. After applying
vascular clips or shunts, or a neurovascular
5 minutes of photic stimulation to the patient, wait
intervention device such as an endovascular
at least 20 minutes before another photic
coil
stimulation.
• Patients under proconvulsant medications or
anesthetics
• Patients with any type of implanted biomedical WARNING
device (e.g. intracranial electrodes, cochlear When electrical stimulation is performed for a
implant or cardiac pacemaker) or any metallic long period, the EEG paste gets dry and
fragments or plate in the head electrical stimulation may cause skin burn
For those patients, there is the possibility of the because the dried paste increases the skin-
following potential hazards: electrode contact impedance. Therefore,
• Tongue or lip laceration periodically check that the paste is moist.
• Mandibular fracture
• Seizure
• Cardiac arrhythmia
• Scalp burn
• Intraoperative awareness
For details, refer to the references for the safety issue:

• MacDonald D.B.: Safety of Intraoperative Transcanial
Electrical Stimulation Motor Evoked Potential
Monitoring. J. Clin. Neurophysiol. 19(5): 416-429, 2002
• MacDonald D.B.: Intraoperative Motor Evoked Potential
Monitoring: Overview and Update. J. Clin. Monitoring
and Computing. 20(5): 347-377, 2006
Using the SLS-3100 stimulator
WARNING
Do not touch the flash lamp assembly because it
gets very hot and can burn the skin.

1. GENERAL
Using a contact lens electrode
WARNING WARNING
Apply the contact lens electrode to the patient’s Remove the contact lens electrode from the
eye under dark red lighting supervised by a patient’s eye after approximately every 45
physician. When attaching a contact lens minutes and give the patient a 10 minute rest. If
electrode, follow the contact lens electrode the electrode is applied for more than 45 minutes,
operator’s manual. it causes a lack of oxygen to the cornea.
WARNING WARNING
When the monitored waveform is abnormal (for • Never check the skin-electrode contact
example, the waveform is flat or hum is impedance while using a contact lens
overlapping), remove the contact lens electrode electrode. Failure to follow this warning injures
from the patient immediately. the patient’s eyes because impedance check
electrical current will be applied.
• When attaching a contact lens electrode, follow
the contact lens electrode operator’s manual.
Using a collodion electrode
WARNING WARNING
• If redness, swelling, itch, or rash appears on Keep collodion/celloidin and acetone away from
the patient’s skin, immediately remove the fire because they are flammable.
collodion from the skin and perform medical
treatment.
• Never allow collodion/celloidin or acetone to
get in the patient’s eyes. If collodion/celloidin
or acetone accidentally gets in the eyes,
immediately and thoroughly wash eyes with
clean water and perform medical treatment
immediately.
• If collodion is swallowed, have the person drink
water and vomit collodion. Perform medical
treatment immediately.
• Collodion is a volatile solvent. Both patients
and medical staff must take extreme care not to
inhale collodion fumes. When using collodion,
make sure there is adequate ventilation. If
excess collodion fumes are inhaled, have the
person lie quietly and keep warm in fresh air.
Perform medical treatment immediately.

1. GENERAL
For the electrocochleogram examination 1
WARNING
Attach the electrodes under the supervision of a
physician in charge.
Using a skin surface stimulating electrode
WARNING
When electrical stimulation is performed for a
long period, the EEG paste gets dry and
electrical stimulation may cause skin burn
because the dried paste increases the skin-
electrode contact impedance. Therefore,
periodically check that the paste is moist.
Other
CAUTION CAUTION
When using the instrument for brain death During measurement, do not change the date
diagnosis, before examination, check and adjust and time. This makes the order of the saved
the date and time of the system. The date and event data and the time of the saved waveforms
time on the screen and recording result are part incorrect.
of important information for the medical record.
CAUTION CAUTION
Do not use the sub-dermal straight needle Never check the skin-electrode contact
electrode for more than one hour as a impedance while using a needle electrode or
measurement electrode for the EEG or evoked while any electrodes are attached at the
potential measurement. When measuring the operation site on the patient’s body. Failure to
EEG or evoked potential for over one hour, use follow this caution causes electrical burn where
the EEG disk electrode. the electrodes are inserted or attached.
CAUTION CAUTION
Before disposing of needle electrodes, check with Do not turn the power off when any program is
your local solid waste officials about proper running. When turning the system off, follow the
disposal. procedure in “Power Off Procedure” in Section 2
of the Operator’s Manual.

1. GENERAL
CAUTION CAUTION
Do not use the Windows remote desktop function. Fuses cut the power off when an abnormality
This function allows unauthorized people to occurs in the systems. Solve the cause of the
remotely access this system. malfunction before replacing the fuse. Use the
correct fuse only. The fuse rating is shown on the
holder.
CAUTION CAUTION
Turn off the stimulator and the MEB-9400 system When using the somato control box, start
power before connecting or disconnecting the stimulation at 0 mA intensity and increase
stimulator for the visual evoked potential gradually. Starting at a higher intensity may
examination. deliver a 100 mA current to the patient.
CAUTION CAUTION
Do not connect or disconnect the somato control Do not use water to clean the somato control box
box cable when the system power is on. because the box contains electrical parts.
CAUTION CAUTION
If the somato control box gets wet, stop use and The sterilization temperature must not exceed
contact your Nihon Kohden representative. 70˚C (158˚F). Electrodes and accessories may
deform or melt above this temperature.
CAUTION CAUTION
Do not wipe an electrode lead or cable with Do not use alcohol or benzine as the contact lens
alcohol. Alcohol causes the lead and cable vinyl electrode cleaner. These solutions deform the
cover to harden. electrode.
CAUTION CAUTION
Do not leave the strap type ground electrode in The current density from the electric stimulator
water or physiological salt solution. It will rust and might be over 2 mA rms/cm2 depending on the
correct measurement cannot be performed. dimensions of the electrode, width of pulse,
intensity and frequency of stimulation.
NOTE
• When using the MEB-9400 application program,
close all other programs. Otherwise, the system
program may not function properly.
• Turn off any screen saver before opening the MEB-
9400 application program.
• Periodically back up data in the system. Otherwise
you may lose data if the computer crashes.

1. GENERAL
MO Disk/CD-ROM Disk Handling and Storing 1
WARNING
The QP-945BK System Program is protected by
copyright law and international treaties.
Unauthorized reproduction or distribution of this
software, or any portion of it, may result in severe
civil and criminal penalties, and will be
prosecuted to the maximum extent possible
under law.
CAUTION CAUTION
Keep the disk away from strong magnetic objects Do not insert or remove a disk while the lamp on
such as a magnet, TV set or speaker. Otherwise, the disk unit is lit.
data in the disk may be lost.
CAUTION CAUTION
Do not touch the disk surface of the recorded Keep the disk away from direct sunlight and high
side (CD-ROM: opposite side of the label side). If temperature. Otherwise, the disk may become
the surface of the disk becomes contaminated deformed.
with any foreign substances such as fingerprints,
reading data may be impossible.
CAUTION CAUTION
Do not handle the disk while smoking or eating. Do not get the disk wet.
CAUTION CAUTION
Do not put a label on top of another label. Do not write on the label after the label is
Remove the old label before applying a new label. attached on the disk. Otherwise, the disk may be
damaged and reading may be impossible.
CAUTION CAUTION
Do not bend the disk, put heavy material on the Clean the disk with a disk cleaner. Do not use
disk, or give a strong impact to the disk. organic solvents such as acetone.
CAUTION
This CD-ROM is not an audio CD and cannot be
played with an audio CD player.

1. GENERAL
Maintenance
CAUTION
Dispose of Nihon Kohden products according to
your local laws and your facility’s guidelines for
waste disposal. Otherwise, it may affect the
environment.
If there is a possibility that the product may have
been contaminated with infection, dispose of it as
medical waste according to your local laws and
your facility’s guidelines for medical waste.
Otherwise, it may cause infection.

Section 2 Electrode/Accessory
2
Handling
EMG Needle Electrode......................................................................................................................................... 2.3
Type of Electrode........................................................................................................................................ 2.4
Electrode Attachment and Connection Procedure..................................................................................... 2.5
Disinfection and Sterilization...................................................................................................................... 2.5
Disk Type Recording Electrode............................................................................................................................. 2.6
Type of Electrode........................................................................................................................................ 2.6
Electrode Placement on Head.................................................................................................................... 2.6
Electrode Attachment and Connection Procedure..................................................................................... 2.8
Handling after Use...................................................................................................................................... 2.8
Disinfection and Sterilization...................................................................................................................... 2.9
Skin Surface Stimulating Electrode.................................................................................................................... 2.10
Type of Electrode .................................................................................................................................... 2.10
Surface Stimulation Electrode.................................................................................................................. 2.11
Finger Electrode....................................................................................................................................... 2.11
Somato Control Box................................................................................................................................. 2.12
Grounding Electrode........................................................................................................................................... 2.14
Type of Electrode...................................................................................................................................... 2.14
Strap Type Ground Electrode Attachment and Connection Procedure.................................................... 2.14
Disk Type Ground Electrode Attachment and Connection Procedure...................................................... 2.15
Handling after Use.................................................................................................................................... 2.15
Disinfection and Sterilization.................................................................................................................... 2.15
Collodion Electrode............................................................................................................................................ 2.16
Necessary Accessories............................................................................................................................ 2.17
Electrode Placement................................................................................................................................ 2.17
Electrode Attachment and Connection Procedure................................................................................... 2.17
Removing Collodion................................................................................................................................. 2.18
Disinfection and Sterilization.................................................................................................................... 2.18
Headphones/Earphones..................................................................................................................................... 2.19
Attachment and Connection Procedure................................................................................................... 2.19
ERG Contact Lens Electrode............................................................................................................................. 2.20
Electrode Attachment and Connection Procedure................................................................................... 2.21
Disinfection............................................................................................................................................... 2.21
Sterilization............................................................................................................................................... 2.21
LED Goggles...................................................................................................................................................... 2.22
Attachment and Connection Procedure................................................................................................... 2.22
CRT Monitor for VEP Stimulation....................................................................................................................... 2.23
Connection............................................................................................................................................... 2.23
Thermistor Probe................................................................................................................................................ 2.24
Connection............................................................................................................................................... 2.24

2. ELECTRODE/ACCESSORY HANDLING
This section describes how to attach and disinfect each electrode or accessory.
Select the suitable electrode according to the examination.

EMG Needle Electrode

2
WARNING
Do not use a needle electrode for electric stimulation. Failure to
follow this warning injures the patient because the needle electrode
is damaged by electrolyzation inside the body.
WARNING
While using an ESU, needle electrodes, silver ball electrodes and
intracranial electrodes must not be used for monitoring unless no
other alternatives are available. If needle electrodes, silver ball
electrodes and intracranial electrodes are used, whenever possible,
disconnect electrodes from the electrode junction box while using
the ESU. Otherwise, current from the ESU might cause skin burn
where the electrodes are attached.
WARNING
To prevent infection, discard needle electrodes after using on a
contagious patient (e.g. hepatitis). Discard electrodes according to
your local regulations.
WARNING
To prevent infection, autoclave the needle electrodes before and
after use.
CAUTION
Do not use the sub-dermal straight needle electrode for more than
one hour as a measurement electrode for the EEG or evoked
potential measurement. When measuring the EEG or evoked
potential for over one hour, use the EEG disk electrode.
CAUTION
Never check the skin-electrode contact impedance while using a
needle electrode or while any electrodes are attached at the
operation site on the patient’s body. Failure to follow this caution
causes electrical burn where the electrodes are inserted or attached.
CAUTION
The disposable needle electrodes are single use only. Do not reuse
even after sterilization.
NOTE
Refer to the needle electrode operator’s manual when using needle
electrodes.
Type of Electrode
• Concentric Needle Electrode: NM-121T/131T/151T, NM-320T/330T
Needle Length: 20 mm (NM-121T/320T)
30 mm (NM-131T/330T)
50 mm (NM-151T)
Needle Diameter: 0.45 mm dia (NM-121T/131T/151T)
0.32 mm dia (NM-320T/330T)
Extension Cable: BM-121S (1 m)
BM-115S (1.8 m)
• Bipolar Needle Electrode: NM-220T/250T

Needle Length: 20 mm (NM-220T)
50 mm (NM-250T)
Needle Diameter: 0.4 mm dia (NM-220T/250T)
BM-215S (1.8 m)
• Disposable Needle Electrode: NM-030T/050T

Needle Length: 30 mm (NM-030T)
50 mm (NM-050T)
Needle Diameter: 0.45 mm dia
BM-115S (1.8 m)
• Monopolar Needle Electrode (Teflon coating): NM-715S/730S,

NM-830S/850S
Needle Length: 15 mm (NM-715S)
30 mm (NM-730S/830S)
50 mm (NM-850S)
Needle Diameter: 0.4 mm dia (NM-715S/730S)
0.5 mm dia (NM-830S/850S)
Extension Cable: BM-800S (with two separate electrode sockets)
• Monopolar Needle Electrode: NM-710T

Needle Length: 13 mm
Extension Cable: BM-800S (with two separate electrode sockets)
• Single Fiber Needle Electrode: NM-640T

BM-115S (1.8 m)
• Macro EMG Needle Electrode:

Single-fiber Macro EMG Electrode: NM-640S
Extension Cable: BM-840S (with two electrode sockets and two 6-pin
connectors)

Concentric Macro EMG Electrode: NM-130S

Needle Diameter: 0.45 mm dia 2
Extension Cable: BM-840S (with two electrode sockets and two 6-pin
connectors)
Electrode Attachment and Connection Procedure

1. Before use, autoclave the needle electrode with the tip of the needle covered
with the protective tube.
2. Connect the electrode extension cable to the electrode lead jack.
3. Connect the EMG needle electrode end to the extension cable, aligning the
dot mark at the end of the electrode with the red dot mark at the cable side.
4. Clean the skin with alcohol at the electrode insertion site.
5. Hold the needle electrode vertically to the skin and insert the needle as
quickly as possible into the muscle to be examined.
Disinfection and Sterilization
WARNING
after use.
Before use, autoclave the needle electrode with the tip of the needle covered with
the protective tube.
After use, disconnect the needle electrode from the extension cable. Wipe blood
off the electrode with cotton moistened with alcohol. Autoclave the electrodes
with the tip of the needle covered with the protective tube. Clean and gas-
sterilize the extension cable.
Autoclave (EMG Needle Electrode)

Sterilizing conditions
Temperature: 121°C, 250°F
Pressure: 100 kPa (1 kgf/cm2)
Period: 30 minutes
Gas-sterilizer (Extension Cable or EMG Needle Electrode)

Sterilizing conditions
Gas: Ethylene oxide gas
Period: 30 minutes with 100% ethylene oxide gas
60 minutes with 50% ethylene oxide gas
120 minutes with 25% ethylene oxide gas

Disk Type Recording Electrode
Type of Electrode
The disk electrode is mainly used as the recording electrode for the surface EMG
or evoked potential testing.
• Disk Electrode (with 2-pin plug, DIN type)

NE-132B (lead length: 1.5 m)
NE-142B (lead length: 0.5 m)
• Surface Electrode (with 6-pin connector, electrode lead jack)

NM-312S (lead length: 1.4 m)
NM-315S (lead length: 2.3 m)
Electrode Placement on Head

Electrode Location
Electrodes must be placed on the patient’s head in the correct positions to
properly derive the spontaneous or evoked potentials from the brain.
The following International 10-20 System (Montreal method) is the
recommended electrode placement on the head.
nasion
FP1 FP2
1 2
F7 F8
F3 FZ F4
13 14
3 19 4 pre-auricular
point
T3 C3 CZ C4 T4
15 5 24 6 16
11 12
A1 A2
P3 P4
T5 T6
7 20 8
17 PZ 18
O1 O2
9 10
inion

Electrode Positions
CZ
1. Divide the longitudinal line of the head into halves and divide the transverse
PZ
FZ line of the head into halves. The point where two lines cross is the vertex. 2
Attach an electrode at the vertex (Cz point) (Fig.1).
FPZ OZ 2. Divide the distance between Cz and the nasion in proportions as shown
and attach an electrode at the point Fz. Do the same for Pz. (Do not attach
electrodes at the points Fpz and Oz.) (Fig.1)
Fig.1
CZ 3. Divide the transverse line of the head into proportions of 10%, 20%, 20%,
20%, 20% and 10% as shown (Fig.2) and attach electrodes at T4, T3, C3 and
C4 C3
C4.
T4 T3
Fig.2
T4 4. Divide the peripheral line passing over Fpz, T4, Oz and T3 into proportions as
T6
F8 shown (Fig.3) and attach electrodes at Fp2, F8, T6, O2, Fp1, F7, T5 and O1.
FP2 O2
FPZ OZ
FP1 O1
F7 T5
T3
Fig.3
5. Take the line passing over F7, Fz and F8 and attach an electrode at the mid-
point (F3) between F7 and Fz as shown (Fig.4).
FP1 FP2
1 2
6. Do the same for F4. Take the line passing over T5, Pz and T6 and do the same
F7 F8
F3 FZ F4 for P3 and P4.
13 14
3 19 4
T3 C3 CZ C4 T4
15 5 24 6 16
11 12
A1 A2
P3 P4
T5 T6
7 20 8
17 PZ 18
O1 O2
9 10
Fig.4


1. Clean the skin site with a cotton pad moistened with alcohol. Wipe the site
with dry gauze to remove oil from the skin.
2. Rub the site with an optimal amount of Skinpure skin preparation gel. For
impedance reduction, wipe the site with dry gauze to remove the corneum
layer of skin.
3. Apply an optimal amount of Elefix EEG paste to the cleaned site and rub the
paste in a 10 mm diameter circle around the site.
silver plate 4. Apply an optimal amount of paste to the disk (cup) of the electrode, and
lead attach it on the pasted site as shown at left.
paste
5. Fasten the electrode on the site with surgical tape if necessary.
skin 6. Connect the active and reference electrode leads to the corresponding
electrode jacks.
7. Connect the grounding electrode lead to the E jack.
NOTE
To short-circuit a channel electrode jack to another channel electrode
jack, use the jumper lead (standard accessory) shown below.
Handling after Use
CAUTION
Do not wipe an electrode lead or cord with alcohol. If the electrode is
wiped with alcohol, the lead/cord vinyl cover will harden.
1. Remove the disk electrode from the site holding the electrode part. To
prevent the internal wire from breaking, do not pull or bend the lead/cable.
2. Soak the electrodes in running water for a while, and clean them gently with
the running water.
NOTE
If any paste remains on the electrode, it will harden and be difficult to
remove.

3. Wipe them with a wet cloth which has been cleaned with invert soap and
water.
2
4. Wipe the electrode lead or cord with water or lukewarm water.
NOTE
If there is a possibility of discontinuity in an electrode lead, check the
lead continuity with a multimeter. Replace the electrode with a new one if
discontinuity is found.
CAUTION
The sterilizer temperature must not exceed 70°C (158°F). The
electrode(s) may deform or melt above this temperature.
Use ethylene oxide gas according to the sterilization procedure if sterilization (or
disinfection) is necessary.

Skin Surface Stimulating Electrode
Type of Electrode
WARNING
When electrical stimulation is continuously performed for a long
period, the felt pads and the EEG paste get dry and the electrical
stimulation may cause skin burn because the dried felt pad or paste
increases the skin-electrode contact impedance. Therefore, always
check that the felt pads are sufficiently moistened with water and that
the paste is moist.
The following three types are provided to electrically stimulate the skin surface
over an examined pathway.
• Surface Stimulation Electrode

NM-410S (for child)
Felt electrode diameter: 4 mm
Center-to-center spacing between electrodes: 10 mm
Cord length: 2 m (with 5-pin male connector)

NM-420S (for adult)
Felt electrode diameter: 8 mm
NM-430S
Variable distance type, lead length 2 m
• Finger Electrode NM-450S

Maximum ring electrode diameter: 25 mm
Electrode material: Stainless
• Somato Control Box RY-441B


Surface Stimulation Electrode

1. Soak the felt pads in water or physiological salt solution.
2
SOMATO connector
2. Connect the somato A → B connection cable (YZ-0172) to the surface
stimulation electrode.
3. Connect the other side of the somato A → B connection cable to the

SOMATO connector on the right side panel of the main unit.
4. Push the two soaked felt pads into each pad holder on the electrode.
Black mark 5. Attach the electrode to the skin surface over the examined nerve.
Felt pad
The black marked side is the negative pole.
Handling after Use

1. Remove the two felt pads from the electrode.
2. Keep the electrode and felt pads dry and clean.
CAUTION
Finger Electrode
1. Apply an optimal amount of Elefix EEG paste to the ring part of each
electrode.
2. Expand the two ring parts and attach them to a digit innervated by the
examined nerve.
NOTE
Wipe the part between the rings with a dry cloth or paper. If too much
paste is applied to the first mounted ring, it may cause a short circuit so
that the digit cannot be stimulated.
3. Connect the somato A → B connection cable (YZ-0172) to the finger

electrode.
SOMATO connector

4. Connect the other side of the somato A → B connection cable to the

SOMATO connector on the right side panel of the main unit.
NOTE
When using the NM-450S finger electrode as a recording electrode,
connect the finger electrode to the electrode lead jack on the electrode
junction box.
Handling after Use

1. Clean the ring part of the electrode with water.
2. Keep the electrode dry and clean.
CAUTION
Somato Control Box

Connection and Operation
1. Apply an optimal amount of Elefix EEG paste to the top of each probe.
2. Connect the somato control box cable to the SOMATO connector on the
main unit.
3. Touch the electrode probes to the skin surface over the examined nerve, and
apply stimulation.
SOMATO connector
CAUTION
When using the stimulation probe, start stimulation at 0 mA intensity
and increase gradually. Starting at a higher intensity may deliver a
100 mA current to the patient.
The somato control box RY-441B controls the stimulation on/off and intensity.
• Single Stimulation
To apply single electric stimulation, press the stimulation ON/OFF button on
either side.
• Continuous Stimulation
To apply continuous electric stimulation, press the stimulation ON/OFF
buttons on both side.

• Stimulus Intensity Control

The electric stimulation intensity adjust buttons controls the stimulation
intensity. 2
To increase the stimulation intensity, press the button on either side.
To decrease the stimulation intensity, press the button on either side.
The stimulation intensity dial on the operation panel can also control the
stimulation intensity.
Handling after Use
CAUTION
Do not use water to clean the somato control box because it
contains electrical parts.
CAUTION
Do not connect/disconnect the somato control box cord when the
power of the instrument is on.
CAUTION
If the somato control box gets wet, stop use and contact your Nihon
Kohden representative.
1. Wipe the paste off the probes with a dry cloth or paper.
2. Keep the somato control box dry and clean.

Grounding Electrode
Type of Electrode
Strap type ground electrodes 1, 2 and 3 consist of an electrode lead and a strap
with Velcro tape to wind it around a limb.
• Ground Electrode NM-503B (for child wrist)

Electrode strap length: 31 cm
Lead length: 1.5 m (with plug)
• Ground Electrode NM-501B (for adult wrist)

NM-501B • Ground Electrode NM-502B (for adult ankle)

• Ground Electrode NM-550B (disk)
Strap Type Ground Electrode Attachment and Connection Procedure

1. Soak the strap thoroughly in a cup containing tap water or physiological salt
solution before use to decrease the skin-electrode impedance.
2. Squeeze the strap softly, and wind it around the limb between the stimulating
and recording electrodes.
NOTE
Keep the strap electrode wet enough and wind it around the limb firmly.
Otherwise, artifact will appear.
3. Clip the electrode lead clip onto the post on the strap, and connect the plug
at the other end of the lead to the patient ground 2-pin jack on the electrode
junction box.

Disk Type Ground Electrode Attachment and Connection Procedure

Use the NM-550B disk type ground electrode.
2
1. Clean a site of the skin with a cotton pad moistened with alcohol. Wipe the
site with dry gauze to remove liquid from the skin.
2. Apply an optimal amount of Elefix EEG paste to the site.
3. Fasten the ground electrode to the site using adhesive tape.
4. Connect the electrode lead to the patient ground 1-pin jack on the electrode
junction box.
Handling after Use

Clean the strap or disk electrode with water, and keep it dry and clean.
CAUTION
Do not leave the strap type ground electrode in water or
physiological salt solution. It will rust and correct measurement
cannot be performed.
CAUTION

Collodion Electrode
WARNING
• If redness, swelling, itch, or rash appears on the patient’s skin,
immediately remove the collodion from the skin and perform
medical treatment.
• Never allow collodion/celloidin or acetone to get in the patient’s
eyes. If collodion/celloidin or acetone accidentally gets in the
eyes, immediately and thoroughly wash eyes with clean water and
perform medical treatment immediately.
• If collodion is swallowed, have the person drink water and vomit
collodion. Perform medical treatment immediately.
• Collodion is a volatile solvent. Both patients and medical staff
must take extreme care not to inhale collodion fumes. When
using collodion, make sure there is adequate ventilation. If excess
collodion fumes are inhaled, have the person lie quietly and keep
warm in fresh air. Perform medical treatment immediately.
WARNING
Keep collodion/celloidin and acetone away from fire because they
are flammable.
NOTE
Refer to the collodion and acetone operator’s manual when using them.
Type of Electrode
The collodion electrode (disk/cup electrode with brim and one or two holes)
records a potential on the scalp for a long time using a collodion or celloidin.
• NE-134A (DIN type)

Cord length: 1.5 m
Electrode material: Ag
• NE-136A (DIN type)

Cord length: 0.7 m
Electrode material: Ag

Necessary Accessories
The following locally available accessories are needed in addition to the optional
collodion electrode set.
2
• Collodion/Celloidin: Bonds the electrode to the scalp.

• Cotton applicator: Spreads the collodion/celloidin on the electrode and scalp.
• Drier: Dries the collodion/celloidin. Only cool air is used.
• Acetone: Dissolves the collodion/celloidin. Nail polish remover can
be used instead of acetone.
Electrode Placement
An electrode on the patient’s head should be placed on the position according
to the international 10-20 system. Refer to “Disk Type Recording Electrode
– Electrode Placement on Head” in this section.

1. Rub the scalp with alcohol where an electrode will be placed. Also rub with
Skinpure skin preparation gel to reduce the scalp impedance, then remove
the gel from the scalp.
2. Push aside the hair covering the scalp to expose the scalp, and continue
holding the collodion electrode on the scalp until step 4.
3. Thinly spread collodion on the electrode brim, scalp and hair roots with a
cotton applicator containing the collodion as shown at left.
4. Dry the collodion with cool air from a drier while holding the electrode. The
collodion dries in about 2 minutes.
NOTE
Do not dry the collodion with warm air from the drier because warm air
causes sweat on the scalp.
5. Repeat steps 3 and 4 a few times to fasten the electrode more securely.
6. Put CardioCream ECG paste in a syringe, and inject the paste into the
fastened electrode through the hole with the syringe as shown at the left until
the paste oozes out.
NOTE
To prevent the injected paste from drying out, spread the collodion over
the hole(s) of the electrode.
When using an electrode with two holes, artifact such as sweat caused
during measurement can be reduced by injecting new paste and forcing
out the old paste and sweat.

7. Connect the collodion electrode leads to the electrode jacks.
8. Connect the grounding electrode to the E jack on the electrode junction box.
Removing Collodion
1. Spread acetone on the coagulated collodion around the electrode with a
cotton applicator containing acetone.
2. Wait a while until the electrode is loosened, then remove it from the head.
3. Wipe the remaining collodion and paste off the scalp.
4. Remove the remaining collodion from the electrode with the acetone and
rinse the paste out of the electrode with running water. Wipe it with a dry
cloth and keep it clean for the next use.
CAUTION

Headphones/Earphones
2
The following headphones and earphones are used as auditory stimulating

accessories for the AEP and other testing.
DR-531B-14 Headphones DR-531B-15 Headphones (for child)
BM-701B Extension cord

YE-103J Earphones
for Headphones and Earphones
Attachment and Connection Procedure

1. <Headphones>
Attach the headphones to the patient’s head so that the speakers are directly
over the ears.
<Earphones>
Insert the earphones into the ears.
NOTE
Confirm that the L and R receivers are attached to the left and right ears
respectively, before use.
2. Connect the headphone or earphone cord to the AUDITORY connector on

the right side panel of the main unit.
AUDITORY connector
Handling after Use

1. Clean the headphones/earphones with cotton moistened with alcohol if they
are dirty.
2. Keep them dry and clean.

ERG Contact Lens Electrode
WARNING WARNING
Apply the contact lens electrode to the patient’s Remove the contact lens electrode from the
eye under dark red lighting supervised by a patient’s eye after approximately every 45
physician. When attaching a contact lens minutes and give the patient a 10 minute rest. If
electrode, follow the contact lens electrode the electrode is applied for more than 45 minutes,
operator’s manual. it causes a lack of oxygen to the cornea.
WARNING WARNING
When the monitored waveform is abnormal (for • Never check the skin-electrode contact
example, the waveform is flat or hum is impedance while using a contact lens
overlapping), remove the contact lens electrode electrode. Failure to follow this warning injures
from the patient immediately. the patient’s eyes because impedance check
electrical current will be applied.
• When attaching a contact lens electrode, follow
the contact lens electrode operator’s manual.
Type of Electrode
• ERG Contact Lens Electrode KE-L*
Lens diameter: 12.0 mm
Electrode material: 24 k gold foil
Cord length: 50 cm
• ERG Contact Lens Electrode KE-S*

Lens diameter: 10.5 mm
Electrode material: 24 k gold foil
Cord length: 50 cm
* Not available in the U.S.

WARNING 2
When attaching an ERG contact lens electrode, follow the ERG
contact lens electrode operator’s manual.
1. Put a few drops of a surface anesthetic such as Benoxil in the patient’s eyes.
2. Put a drop of cornea protecting agent such as Scopisol on the inside curved
portion of the contact lens.
3. Insert the lower edge of the contact lens to the patient’s lower eyelid pulling
the lower eyelid down.
4. Insert the upper edge of the contact lens to the upper eyelid pulling the upper
eyelid up.
5. Connect the contact lens electrode lead to the electrode jack.
Disinfection
CAUTION
Do not use alcohol or benzine as the electrode cleaner. These
solutions will deform the electrode.
1. Clean the contact lens electrode with a disinfection solution such as Osvan
liquid, Hibitane liquid or invert soap.
2. Rinse the solution out of the electrode with tap water.
3. Keep the electrode dry and clean for the next use.
Sterilization
Refer to the manual of the purchased electrode for details.

LED Goggles
The following goggles are used as the flash visual stimulating accessory for the
VEP and other testing.
BM-702B Extension cord

LS-102J LED Goggles
for LS-102J LED Goggles
Attachment and Connection Procedure

1. Attach the LED Goggles LS-102J to the patient’s head.
NOTE
Do not bind the goggles strap too tightly to the head. If the strap is too
tight, artifact will appear during measurement.
2. Connect the LS-102J cord to the GOGGLE connector on the right side panel
of the main unit.
GOGGLE connector
Handling after Use

1. Clean the LS-102J with an alcohol moistened cotton if it is dirty.
2. Keep them dry and clean.

CRT Monitor for VEP Stimulation

2
The following monitor is used as the checker/stripe reversal or flash stimulus

CRT display for VEP and other testing.
NOTE
• A locally available CRT monitor with an analog RGB input jack can be
used as the pattern reversal/flash stimulus CRT display instead of the
Nihon Kohden CRT Monitor.
• Use an isolation transformer with a CRT monitor.
CRT Monitor
Connection
1. Connect the RGB cable provided with the CRT monitor to the D-SUB
connector on the rear of the CRT monitor.
2. Connect the other side of the cable to the PATTERN connector on the right
side panel of the main unit.
D-SUB connector
CRT Monitor
PATTERN connector

Thermistor Probe
The 409J thermistor probe is used for monitoring temperature and automatically
displaying temperature on the screen.
The temperature monitoring function is only available for the MEB-9400A

EMG/EP measuring system.
NOTE
Only use the 409J thermistor probe.
Connection
Connect the thermistor probe to the TEMP connector on the right side panel of
the main unit.
TEMP connector
Handling after Use

After use, clean and disinfect the thermistor probe according to the
accompanying document of the thermistor probes.

Section 3 Somatosensory Evoked
Potential 3
3-1
Section 3-1 Measurement – Basic.................................................................................................................... 3.1.1
Section 3-2 Measurement – SEP/SSEP/ECSP................................................................................................ 3.2.1 3-2
Section 3-3 Measurement – ECG SSEP.......................................................................................................... 3.3.1
Section 3-4 Calculation..................................................................................................................................... 3.4.1 3-3
3-4
Examination Guide MEB-9400 3.0.1

Section 3-1 Measurement – Basic
3
3-1
Operation Flow.................................................................................................................................................. 3.1.2
Entering the Patient Information........................................................................................................................ 3.1.4
Selecting the Examination Item......................................................................................................................... 3.1.5
Entering the Examination Information............................................................................................................... 3.1.6
Checking and Changing Measurement Settings............................................................................................... 3.1.7
Measurement Window Description.................................................................................................................. 3.1.11
Monitoring the Raw Waveforms (Monitor Window)................................................................................ 3.1.11
Starting Stimulation and Acquisition (Sweep Window).......................................................................... 3.1.12
Starting Averaging (Average Window)................................................................................................... 3.1.13
Stopping Monitoring, Acquisition or Averaging to Display, Measure or Save a Waveform
(Stop Window)....................................................................................................................................... 3.1.14

3. SOMATOSENSORY EVOKED POTENTIAL
Operation Flow
This is a typical example. You may not need to do all these. Operating
procedures differ according to the examination program.
Enter the patient information.
Select the examination program.
Enter the examination information.
Check and if necessary change the measurement settings.
Connect the electrode leads and SOMATO control box to the

appropriate instrument.
Attach the electrode to the patient.
Check the raw waveforms. Use the Monitor window.
Start stimulation and display evoked waveforms. Use the Sweep

window.
Start averaging the waveforms. Use the Average window.
3.1.2 Examination Guide MEB-9400

3-1. MEASUREMENT – BASIC
3
Stop averaging waveforms.
3-1
Save the acquired waveforms and data in memory.
Mark the waveforms for autonomic calculation. The results are

displayed in the Evoked Measurement window.
Save the waveforms and data in the hard disk.

Entering the Patient Information
When the system power is turned on, enter the patient information at first.
1. Turn the system power on. The Main Menu window automatically opens.
If the Main Menu window is minimized:
• Press the MENU key on the operation panel.
• Or, click the Main Menu on the Task bar.
2. Click the New Patient button on the Main Menu window. The Patient
Information dialog box opens.
3. Enter the patient information such as, ID No. Name, etc. For details, refer to
the MEB-9400 operator’s manual.
4. Click the OK button to close the Patient Information dialog box.

Selecting the Examination Item
On the Main Menu window, select the examination program. Each program has 3
its own measurement and stimulation settings.
3-1
To open an examination program,
1. Click the category tab.
2. Click the examination program button.
Or,
1. Press the Tab key on the keyboard.
2. Select the examination program with the ←, →, ↑ or ↓ key on the keyboard,

then press the Enter key.
Or,
1. Press the MUSCLE/TEST ↑ ↓ key on the operation panel to select

examination program.
2. Press the SIDE/SET key on the operation panel.

Category tab
Examination Program button
To close the examination program,

• Click the Close button on the menu bar.
• Or, from the File menu, select Exit.
When the currently displayed waveform is not saved, a dialog box opens to
prompt you to save the waveform.
You can enter comments in the Main Menu window and edit categories and
programs. Refer to the MEB-9400 operator’s manual for details.

Entering the Examination Information
You can enter examination information in the Examination Information dialog

box.
1. Open the Examination information dialog box.

• Click the Examination Information button on the Tool bar.
• Or, click the Examination Information function button on the bottom of
the window.
Measurement Condition Examination Patient Gather
Marking Processing Superimpose
Table Table Information Information Waves
F1 F2 F3 F4 F5 F6 F7 F8
• Or, select Examination Information from the Measurement menu.

Measurement menu → Display Table → Examination Information
2. Enter the examination information with the keyboard. You can enter the
preset examination information with the list box.
3. Enter the comment.
4. Click the OK button. The Examination Information dialog box closes.
• To clear the entered examination information, click the Clear All button.
• To cancel entering, click the Cancel button.
For details, refer to the MEB-9400 operator’s manual.

Checking and Changing Measurement Settings
Before starting measurement, you need to check the measurement settings and 3
change them if necessary on the Set Conditions window.
3-1
1. Click the button on the Tool bar to open the Set Conditions window.
2. Select the condition tab that you want to check. The Condition tabs are at the
top of the window.
Condition tab
3. Select the item you want to change.
For the procedure to change the settings, refer to the MEB-9400 operator’s
manual.

Amp. Page
Item Description
Input Select Selects the input source from either JB (Electrode junction box) or OFF (No
input). You can change the input source to JB or OFF by pressing the Ctrl key +
F1 to F4 key on the keyboard. The F1 to F4 keys correspond to channels 1 to 4.
Electrode (−) Selects a pair of electrode names for each channel to acquire the waveforms
Electrode (+) from A1, A2, A+, Fz, Pz, C3, C4, Cz, Oz, LO, RO, LT, RT, C5S, EP1, EP2, X1
to X8 and DIN.
Sens. (/div) Selects the amplifier sensitivity. When “additional amplifier” is set to “Velocity”,
this selects the amplitude of the velocity waveform.
Hi-cut Selects the high-cut filter frequency of the amplifier.
Lo-cut Selects the low-cut filter frequency of the amplifier.
Acquisition Page
Item Description
Analysis (/div) Selects the analysis time for horizontal length (scale/division) for trigger sweep
and average.
Preset Count Selects the number of waveforms to acquire for average.
Reject Level Selects the amplitude threshold (div) to select the acquired waveforms for
averaging. When the amplitude of the waveform exceeds the upper or lower
threshold, it is not included in averaging. Select “OFF” to not use this function.
Common Reject When a large noise interfered with a Sweep window waveform during averaging,
the affected waveform can be removed from averaging. Common Reject selects
the method to remove the waveform. The limit is set at Reject Level.
ON: When noise interferes with a sweep waveform acquired from one channel
and the waveform amplitude exceeds the Reject Level, the waveform and
all other sweep waveforms which were simultaneously acquired from other
channels are also removed.
OFF: When noise interferes with a sweep waveform acquired from one channel
and the waveform amplitude exceeds the Reject Level, only the sweep
waveform is removed from averaging.
Alternate Average Check this box to alternately acquire the waveforms in two stages (first stage
(Odd/Even) then second stage).
Electric Page
Item Description
Intensity Selects the intensity of the electrical stimulation signal. You can type in
the intensity with the keyboard. You can also change the intensity with the
stimulation intensity dial on the operation panel.
Duration Selects the duration of the electrical stimulation signal. You can type in the width
with the keyboard. You can also change the duration with the STIM DURATION
key.
Trigger Page
Item Description
Stim Rate Selects the stimulation frequency. You can type in the frequency with the
keyboard.

Labeling Page
Item Description
Label Selects the label for marking the waveform.
Measurement Table Selects the Measurement Table window Type I or Type II.
3
Type
3-1
Misc. Page
Item Description
Show Intensity Window Check this box to display the window which displays the stimulation intensity.
Show Temperature Check this box to display the skin temperature window.
Window*
Show Measurement Check this box to display the Measurement window for each examination
Window program when the examination program opens.
Show Nerve/Muscle Check this box to display the table to enter nerve name or muscle name when the
Table examination program opens.
Foot Switches Left, Selects the function for the left and right foot switches.
Right
Auto Store Check this box to automatically save the acquired waveform in temporary
memory when the STOP key on the operation panel is pressed.
* Only available for the MEB-9400A EMG/EP measuring system.
Settings for ECG-SSEP examination program
Item Description
Trigger Mode This item selects the trigger source from the following modes to display a
time-locked waveform.
Recurrent Mode: Generates a trigger at the Stim Rate which is set in the
Trigger page of the Set Conditions window.
Random Mode: Generates a trigger at random rate within ± 50% of the Stim
Rate.
Signal Mode: Generates a trigger each time the ECG waveform exceeds the
preset threshold.
Signal Trigger Channel This item selects the channel of the waveform to be used as a trigger source.
When the Signal is selected at Trigger Mode, this setting is needed.
Trigger Slope This item selects which part of the trigger source waveform (ECG waveform)
to trigger. When the Signal is selected at Trigger Mode, this setting is needed.
Rising: Upward slope of trigger source waveform
Falling: Downward slope of trigger source waveform

The relation between trigger level and trigger position is as follows.
When the Trigger Slope is set to Rising:
LEVEL 1 (1)
LEVEL 2 (2)
ECG
LEVEL CURSOR at (1)
LEVEL CURSOR at (2)

When the cursor is at LEVEL 2,
trigger appears at two places,
therefore control is needed.

Measurement Window Description
Four operation modes are used for measurement in this instrument. Select a 3
mode with the MONITOR, STIM/SWEEP, ANALYSIS or STOP key on the
operation panel. 3-1
Monitoring the Raw Waveforms (Monitor Window)

Press the MONITOR key on the operation panel. The Monitor window opens
and the raw waveforms are displayed. Check that the electrodes are properly
attached and that there is no artifact.
Amplifier sensitivity
Monitoring time
Foot switch functions

Starting Stimulation and Acquisition (Sweep Window)

Press the STIM/SWEEP key on the operation panel. Stimulation starts and
the Monitor window changes to the Sweep window and, in the ECG-SSEP
examination, the Signal Level Trigger Monitor window opens. Evoked
waveforms are displayed on the Sweep window.
To display, measure or save a waveform in the hard disk, press the STOP key.
Stimulation and acquisition stops and the Sweep window changes to the Stop
window.
Number of acquired waveforms
Preset number of waveforms to acquire
Sensitivity

Starting Averaging (Average Window)

Press the ANALYSIS key on the operation panel. The Sweep window changes
to the Average window and averaging of the acquired waveforms starts. You can
set the number of waveforms to average. The averaged waveform is displayed on
3
the Average window.
3-1
Averaging stops and the Average window changes to the Stop window.
Number of averaged waveforms
Number of rejected
Preset number of waveforms to average waveforms
Sensitivity


(Stop Window)
Press the STOP key on the operation panel. The Monitor window, Sweep
window or Average window changes to the Stop window and monitoring,
acquisition or averaging stops. The latest acquired or averaged waveforms are
displayed on the Stop window and you can measure the waveforms or save them
in the hard disk.
Number of acquired or averaged waveforms

Number of rejected
Preset number of waveforms to acquire or average waveforms

Section 3-2 Measurement –
SEP/SSEP/ESCP 3
General.............................................................................................................................................................. 3.2.2
Examination Programs............................................................................................................................ 3.2.2 3-2
Features.................................................................................................................................................. 3.2.2
Preparation........................................................................................................................................................ 3.2.3
Electrode Attachment and Connection.................................................................................................... 3.2.3
Checking Skin-Electrode Contact Impedance................................................................................................... 3.2.7
Measurement..................................................................................................................................................... 3.2.8
Selecting the Program and Changing Measurement Settings................................................................ 3.2.8
Measurement Procedure......................................................................................................................... 3.2.8
Deleting Waveforms................................................................................................................................ 3.2.9
Saving Data on Disk................................................................................................................................ 3.2.9
Printing Data........................................................................................................................................... 3.2.9

General
Examination Programs
• SEP: Somatosensory evoked potential
Middle or long latency (100 ms or more)
Factory default setting is analysis time at 10 ms/div, 1 channel
measurement.
• SSEP: Short-latency somatosensory evoked potential
Short latency (30 ms or less)
measurement.
• ESCP: Evoked spinal cord potential
measurement.
Features
A 2 channel or 4 channel electrode junction box can be used. With the 4 channel
electrode junction box, up to 104 response waveforms can be displayed on the
window. (4 channels × 26 stages)
SEP Stop window
SSEP Stop window

3-2. MEASUREMENT – SEP/SSEP/ESCP
Preparation
Electrode Attachment and Connection 3

1. Connect the recording electrode (disk electrode) leads to the electrode jacks
as shown in the next page.
3-2
3. Connect the surface stimulation electrode lead to the SOMATO connector

on the right side panel of the main unit with the somato A → B connection
cable. When using the SOMATO control box, connect the SOMATO control
box cord to the SOMATO connector on the right side panel of the main unit.
4. Use a piece of cotton moistened with alcohol to clean the patient’s skin
where electrodes will be attached. Rub the skin with an optimal amount of
Skinpure skin preparation gel to reduce artifact. Wipe the skin thoroughly
with dry gauze to remove any moisture and gel from the skin.
5. Attach the recording electrodes with paste to the optimal sites as shown in
the next page.
6. Attach the grounding electrode between the active electrode and the
stimulating electrode.
7. Check the skin-electrode contact impedance.
NOTE
The skin-electrode contact impedance should be 5 kΩ or less.
8. Soak the felt pads of the surface stimulation electrode with water.
NOTE
• Do not short-circuit between the felt pads with water.
• Do not touch the stimulating electrode with the grounding electrode.
This causes stimulus artifact.
• To prevent noise and artifact, place the patient and the electrode
junction box away from the system and bind the recording electrode
leads together with tape.
• Have the patient relax on a reclining chair or a bed with eyes closed.
• To prevent EMG of the neck, ask the patient to not move his/her head.
• To prevent EMG of the chin, ask the patient to open his/her mouth
slightly.

<SEP at the contralateral Shagass point on the brain evoked by the stimulating median nerve at the right
wrist>
Recording electrode placement Stimulation/Ground electrode placement
Grounding electrode
7cm
Stimulation electrode
CZ
2cm
A1 C3'
CH1 Active electrode (−)

CH1 Reference electrode (+)
(A Derivation in which Fz is
reference electrode is also used.)
Electrode lead connection
Example: JB-944 BK (4 channel, without montage function)
A1
C3' Grounding electrode

<SSEP to upper extremity stimulation (Median nerve at left wrist)>
Grounding electrode
3
3-2

Example: JB-944 BK (4 channel, without montage function) CPc
Grounding electrode
(−) (+)
jumper lead C5S EPi
CH 1 CPc Fz
CH 2 CPc EPc
CH 3 C5S Fz
CH 4 EPi EPc
jumper lead jumper lead
Fz EPc

<SSEP to lower extremity stimulation (Posterior tibial nerve at right malleolus)>
Grounding electrode
Fpz
C5S
Medial malleolus
CPz Posterior tibial nerve
T12S
CPi
ICc
Electrode lead connection Grounding electrode

Example: JB-944 BK (4 channel, without montage function) T12S
CPi CPz C5S ICc
(−) (+)
CH 1 CPi FPz
CH 2 CPz FPz
CH 3 FPz C5S
CH 4 T12S ICc
jumper lead
jumper lead
Fpz

Checking Skin-Electrode Contact Impedance
3
WARNING
• Never check the skin-electrode contact impedance while using a
contact lens electrode. Failure to follow this warning injures the
patient’s eyes because impedance check electrical current will be 3-2
applied.
• When attaching a contact lens electrode, follow the contact lens
electrode operator’s manual.
CAUTION
1. Click the Impedance Check button on the Tool bar.

Or, select Impedance Check from the Examination menu.
Examination menu → Impedance Check
The Impedance Check dialog box opens.
2. Select the impedance threshold in the Impedance Threshold area.
When skin-electrode contact impedance check is started, the electrode being

checked is displayed in black in the Impedance Check dialog box.
Skin-electrode contact impedance check indication:

Impedance Electrode in the Impedance Check dialog box
≤ Threshold Displayed in green with the measured impedance.
> Threshold Displayed in black on orange.
Unused electrode Dimmed
3. Click the Close button on the menu bar to complete the impedance check.

Measurement
Selecting the Program and Changing Measurement Settings

Refer to the MEB-9400 operator’s manual as necessary to prepare the equipment
and settings.
1. Select the SOMATO tab in the category tab on the Main Menu window. The
examination program buttons on the Main Menu window change.
2. Select the SEP, SSEP or ESCP examination program on the Main Menu
window. The selected examination program window opens.
3. Click the button on the Tool bar to display the Set Conditions window
to check or change the measurement settings. Refer to “Checking and
Changing Measurement Settings” in this section.
Measurement Procedure
1. Press the MONITOR key on the operation panel to monitor the raw
waveform from the recording electrode. Check that there is no artifact.
2. Check that the stimulus intensity is set to 0 mA. If not, press the RESET key
on the operation panel.
3. Press the STIM/SWEEP key on the operation panel to display the waveforms
and stimulation output.
4. Place the stimulating electrode on the stimulation site.

When using the surface stimulation electrode, fix it to the site with the strap
(included in NM-420S, option). The black marked side of the NM-420S
surface stimulation electrode is the minus side.
5. Turn the stimulation intensity dial on the operation panel to gradually

increase the stimulation intensity until the muscle contracts.
6. Press the ANALYSIS key on the operation panel to start averaging. The
artifact is removed from averaging.

When the averaging reaches the preset value (set at Preset Count on
the Acquisition page of the Set Conditions window), the averaging and
stimulation stop automatically.
• To stop during averaging, press the STOP key on the operation panel.
• To reset/restart averaging, press the ERASE key on the operation panel.

7. Save the waveforms temporarily in memory.

• When Auto Store is set to ON (default setting: ON) on the Misc. page of
the Set Condition window, the averaged waveforms are temporarily saved
in memory when averaging finishes.
• When Auto Store is OFF, click the Store button on the Tool bar or press 3
the STORE key on the operation panel to save the waveform.
8. To check the reproducibility, repeat steps 1 to 7.

3-2
9. From the Stop window, you can display the measurement results in the
Measurement Table window when the waveforms are marked.
• To mark the waveforms, refer to “Marking”.
• To display the Measurement Table window, refer to “Measurement Table
Window”.
Deleting Waveforms
You can delete unnecessary waveforms by the following procedure.
1. Select the waveforms to delete on the Stop window with the ALL/INDV
key and SELECT ↓ ↑ key on the operation panel or mouse. The selected
waveforms have a different color. You can also select the waveform(s) by
clicking the All, Channel or Individual button on the Tool bar.
Individual button All button ALL/INDV key: Selects one or more waveforms. The All, Channel
or Individual button on the Tool bar indicates the
selected waveform(s).
The All button is down: All waveforms in one stage or site are
selected.
The Channel button is down: All waveforms in one channel are selected.
Channel button
The Individual button is down: One individual waveform is selected.
SELECT ↓ ↑ key: Selects the stage if the ALL button is selected.

Selects the channel if the Channel button is selected.
2. Press the ERASE key on the operation panel. The message confirming
deletion appears.
3. Check that the waveform selection is correct, and press the ERASE key. The
selected waveforms are deleted.
Saving Data on Disk

To save the measurement results and the waveforms on the hard disk, refer to the
MEB-9400 operator’s manual.
Printing Data
For printing, refer to the MEB-9400 operator’s manual.
Section 3-3 Measurement – ECG-SSEP
3
General.............................................................................................................................................................. 3.3.2
Features.................................................................................................................................................. 3.3.2
Preparation........................................................................................................................................................ 3.3.3
Electrode Attachment and Connection.................................................................................................... 3.3.3 3-3
Measurement..................................................................................................................................................... 3.3.6
Printing Data........................................................................................................................................... 3.3.8

General
Short-latency somatosensory evoked potential triggered by each QRS complex

on the ECG can be measured on a far field with the ECG-SSEP program.
Features
• A 2 channel or 4 channel electrode junction box can be used. With the
4 channel electrode junction box, up to 104 response waveforms can be
displayed on the window (4 channels × 26 stages). However, one of these
channels is used for ECG input (default setting: channel 1).
• Trigger level of ECG waveform can be set by using the CURSOR dial.

3-3. MEASUREMENT – ECG-SSEP
Preparation
Electrode Attachment and Connection 3

as shown in the next page.
3-3
4. Connect ECG electrode leads to CH 1.
where electrodes will be attached. Rub the skin with an optimal amount of
Skinpure skin preparation gel to reduce artifact. Wipe the skin thoroughly
with dry gauze to remove any moisture and the gel from the skin.
6. Attach the recording electrodes with paste to the optimal site as shown in the
next page.
7. Attach the grounding electrode between the active electrode and the
stimulating electrode.
8. Check each skin-electrode contact impedance.
NOTE
10. Attach the ECG electrodes on the optimal site as shown in the next page.
NOTE
slightly.

Example:
<SSEP at the contralateral Shagass point on the brain evoked by the stimulated median nerve at the left
wrist>
Recording electrode placement ECG/Stimulation/Ground electrode placement
7cm
2cm
C4'
C4'
EP1 Grouding electrode
C5S Stimulating electrode ( )

EP1 Stimulating electrode ()
ECG (+)
ECG ( )
Reference electrode (+)
Electrode lead connection Grounding electrode
ECG (+) EP1

Example: JB-944BK (4 channel, without montage function) ECG (–) C4' C5S
(−) (+)
CH1 ECG ECG
CH2 C4’ Reference
CH3 C5S Reference
CH4 EP1 Reference
jumper lead
jumper lead
Reference electrode

3
WARNING
patient’s eyes because impedance check electrical current will be
applied.
• When attaching a contact lens electrode, follow the contact lens 3-3
CAUTION




Measurement

and the settings.
1. Select the SOMATO tab in the Category tab on the Main Menu window. The
2. Select the ECG-SSEP examination program on the Main Menu window. The
ECG-SSEP examination program window opens.
to confirm or change the measurement settings. Refer to “Checking and
3. Press the STIM/SWEEP key on the operation panel to display the Signal
Level Trigger Monitor window for ECG trigger control and the response
waveforms evoked by each electric stimulation from the stimulation
electrode.
4. Turn the cursor dial on the operation panel to set the trigger level cursor on
the peak of R wave of the ECG waveform.
5. Place the stimulating electrode on the stimulation site.

When using the surface stimulation electrode, fix it to the site with the strap
(included in NM-420S, option). The black marked side of the NM-420S
surface stimulation electrode is the minus.
6. Turn the stimulation intensity dial on the operation panel to gradually

increase the stimulation intensity until the muscle contracts.

stimulation stop automatically. 3
3-3
the Set Condition window, the averaged waveforms are temporarily saved
• When Auto Store is OFF, click the Store button on the Tool bar or press
[For Reference]
Stimulation output initial setting:
set with “CURSOR”
TRIGGER LEVEL
ECG
STIM DELAY = 400 ms
MAIN TRIGGER
WAVEMODE = TRAIN STIM INTERVAL = 100 ms
STIMULATION OUTPUT
TRAIN NUMBER = 3
STIMULATION TRIGGER
ANALYSIS TIME = 3 ms/DIV
AVERAGE
9. To confirm the reproducibility, repeat steps 2 to 8.
10. From the Stop window, the measurement results can be displayed in the
Measurement Table window when the waveforms are marked.
• To mark the waveforms, refer to “Marking”.
• To display the Measurement Table window, refer to “Measurement Table
Window”.

Deleting Waveforms
All button ALL/INDV key: Selects one or more waveforms. The All, Channel
Individual button or Individual button on the Tool bar indicates the
selected.
Channel button

deletion appears.
3. Confirm that the waveform selection is correct, and press the ERASE key.
The selected waveforms are deleted.
Saving Data on Disk

Printing Data

Section 3-4 Calculation
3
General.............................................................................................................................................................. 3.4.2
Marking.............................................................................................................................................................. 3.4.3
Manual Marking....................................................................................................................................... 3.4.3
Setting a Mark at a Time............................................................................................................... 3.4.3
Moving a Mark......................................................................................................................................... 3.4.5
Deleting Marks........................................................................................................................................ 3.4.5 3-4
Deleting an Individual Mark........................................................................................................... 3.4.5
Deleting All Marks......................................................................................................................... 3.4.5
Measurement Table Window.............................................................................................................................. 3.4.6
To Open the Measurement Table Window............................................................................................... 3.4.7
To Close the Measurement Table Window.............................................................................................. 3.4.7
Measurement Table Window Type I Description................................................................................................ 3.4.8
Evoked Measurement Table - Latency Window....................................................................................... 3.4.8
Entering Normative Data............................................................................................................... 3.4.8
Annotating a Waveform................................................................................................................. 3.4.9
Evoked Measurement Table - Mark Pair Window.................................................................................... 3.4.9
Selecting Measurement Items....................................................................................................... 3.4.9
Setting Pairs................................................................................................................................ 3.4.10
Entering the Waveform Number.................................................................................................. 3.4.10
Evoked Measurement Table Window Type II Description................................................................................ 3.4.11
Evoked Measurement Table Window..................................................................................................... 3.4.11
Annotating a Waveform............................................................................................................... 3.4.12
Selecting Measurement Items..................................................................................................... 3.4.12
Setting Pairs................................................................................................................................ 3.4.12
SSEP Measurement Table Window....................................................................................................... 3.4.13
Displaying Normative Range....................................................................................................... 3.4.14
Creating the CSV File................................................................................................................. 3.4.14
Saving Data on Disk........................................................................................................................................ 3.4.16
Condition Table Window.................................................................................................................................. 3.4.16
Annotating a Waveform................................................................................................................................... 3.4.17

General
For SEP, SSEP, ESCP and ECG-SSEP, the following calculation operations are
common.
• Marking
• Displaying the Measurement Table window
• Displaying the Condition Table window
• Annotating a waveform

3-4. CALCULATION
Marking
You can manually set marks to measure amplitude and latency. 3
Manual Marking
Marks can be set manually.
There are two ways to manually set marks on the waveform.
• Setting one mark at a time
• Setting marks according to the settings on the Labeling page on the Set 3-4
Conditions window
Setting a Mark at a Time
1. Click the Marking function button on the Stop window.
Measurement Condition Second Examination Nerve Patient

Marking Input Superimpose
Table Table Sens. Information Information
F1 F2 F3 F4 F5 F6 F7 F8
The Latency window and Mark Label window appear, and a vertical cursor
appears on the wave area.
Latency window Mark Label window
Vertical cursor

2. Do one of the following to set a mark.
Setting a mark with the mouse

1) On the Mark Label window, click a mark to add. The selected mark is
highlighted.
2) On the wave area, click a waveform at the point you want to add the mark.
The selected mark appears on the clicked point. On the Mark Label window,
the lower mark label is highlighted. Up to 12 marks can be set on one
waveform.
Setting a mark with the function buttons

1) Select the waveform to be marked with the SELECT ↓ ↑ key on the
operation panel.
2) Turn the CURSOR dial to move the vertical cursor to the position to be
marked.
3) Click the mark label function button you want to set. The mark is set on the
cursor point. The latency (ms) at the point is displayed under the selected
mark label function button.
When the mark label you want to set is not on the function buttons
a) Click the function button to display the next function buttons.
b) Click the desired mark label on the Mark Label window or select the
mark label with the F2 (Select Prev. Mark) or F3 (Select Next Mark)
key on the keyboard. To select marks listed in the upper Mark Label
window, press the F2 key. To select marks listed in the lower Mark
Label window, press the F3 key. The selected mark label is highlighted.
Select Select Wave Delete End

Add Mark
Prev. Mark Next Mark Annotation Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
c) Press the F1 (Add Mark) key on the keyboard. The mark is set at the
cursor point.

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8
3. Click the End Marking function button or press the F8 (End Marking) key

3-4. CALCULATION
Moving a Mark
Do one of the following.
• Drag the mark to the desired position. You can move a mark with this
3
procedure on the Stop window without opening the Mark Label window.
• On the Mark Label window, select the mark label you want to move. Then,
do “Setting a Mark at a Time” procedure. The selected mark move to the new
position.
Deleting Marks 3-4
Deleting an Individual Mark
There are two procedures.
• When the mark label you want to delete is on the function button, you can
delete the mark by clicking the function button twice.
• Or,
1. On the Mark Label window, click the mark label to delete. The cursor moves
to the mark position.
2. Click the Add Mark function button or press the F1 key on the operation
panel.
The mark is deleted.

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8
Deleting All Marks
Click the Delete Mark function button or the F6 key on the keyboard.
All marks on the selected waveform are deleted.

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8

Measurement Table Window
There are two types of Measurement Table windows, Type I and Type II. Select
either Type I or Type II on the Labeling page on the Set Conditions window.
Type I: Displays the Evoked Measurement Table - Latency window and the
Evoked Measurement Table - Mark Pair window.
Type II: For SEP, SSEP or ESCP, the Evoked Measurement Table - Latency
window and the Evoked Measurement Table - Mark Pair window are
combined into one table window.
For SSEP and ECG-SSEP, the SSEP Measurement Table is displayed.
Type I Type II
Evoked Measurement Table - Latency window Evoked Measurement Table
SSEP Measurement Table

Evoked Measurement Table - Mark Pair window

3-4. CALCULATION
To Open the Measurement Table Window

On the Stop window, click the tool button or click the Measurement Table
function button.
Marking
Measurement Condition Second Examination Nerve
Input
Patient
Superimpose 3
F1 F2 F3 F4 F5 F6 F7 F8
To Close the Measurement Table Window

3-4
Click the button on each window.
Or click the tool button or the Measurement Table function button again.

Measurement Table Window Type I Description
When the Type I is selected on the Labeling page on the Set Conditions window,
the following windows open.
When the waveforms are marked, waveform measurement starts automatically

and the results can be displayed in the Measurement Table window.
Evoked Measurement Table - Latency Window

Displays the latency, amplitude and area between the marks. The latency,
amplitude and area are automatically calculated and displayed.
No.: Waveform number

The waveforms which are displayed in the wave area are
automatically displayed on the Evoked Measurement Table-
Latency window in waveform number order.
Annotation: Annotation for each waveform
Latency: Latency from the trigger point to the onset mark
Stim.1, Stim.2: Stimulation output (electrical stimulation output)
Stim.2 is displayed only for the data measured with other
model instruments.
Entering Normative Data
1. To display the Normative Data column, click the Show ND check box on the
Evoked Measurement Table - Latency window. A check mark appears in the
box, and the Normative Data column appears.
2. Click the column which you want to enter the normative data in. The cursor
appears in the clicked column.
3. Enter the normative data with the keyboard. The data remains at the next
measurement.

3-4. CALCULATION
Annotating a Waveform
Whether or not to display the Annotation can be set on the Labeling page of the
Set Conditions window.
To annotate a waveform,
1. Click the No. you want to annotate.
3
2. Enter an annotation from the keyboard or the annotation list.

To open the annotation list, click the down arrow on the right of the
Annotation column.
You can also annotate a waveform on the Wave Annotation window.

3-4
Evoked Measurement Table - Mark Pair Window
Selecting Measurement Items
Click the button of the Type box. The selectable items are displayed in the
drop down list. Items are Interval, Amplitude, Area, Compare and (none).
Click an item in the list. The clicked item is displayed in the Type box.
Interval: Latency between the two input marks

When two waveform numbers (for example A1-B1) are input, the
latency between the two waveforms is displayed.
Amplitude: Potential difference between the two input marks on the selected
waveform
Area: Area between the two input marks on the selected waveform
Compare: Calculates the difference between the two values displayed in one
row above and two rows above the selected row.
When the items differ (for example Interval and Area), or only one
row is displayed, calculation cannot be done.
none: When none of the items above is selected, none is displayed.

Setting Pairs
To set a pair, enter two mark labels in the Mark Pair From box and the Mark Pair
To box. Up to 3 pairs can be set. The “-” is displayed between the boxes which
make a pair.
To enter a mark label in the box, click the button of the box. Twelve mark
labels are displayed in the drop down list. Click the desired mark label. The mark
label is displayed in the box.
Example
Mark Pair From box Mark Pair To box
Type box
The mark in the Mark Pair To box
N11
A1
Ep
A3
Calculation value
The mark in the Mark Pair From box
Entering the Waveform Number
Use the keyboard to enter the waveform number. When you set two waveform
numbers (only for Interval), enter waveform numbers in the box in the format
“A1-B1”.
No. box

3-4. CALCULATION
Evoked Measurement Table Window Type II Description
SEP/ESCP/ECG-SSEP 3
When the Type II is selected on the Labeling page on the Set Condition window,
the Evoked Measurement Table window is displayed. The Evoked Measurement
Table - Latency window and the Evoked Measurement Table - Mark Pair
window are combined into the Evoked Measurement Table window.
SSEP
When the Type II is selected on the Labeling page on the Set Condition window,
3-4
the SSEP Measurement Table window is displayed. The Evoked Measurement
Table- Latency window and the Evoked Measurement Table - Mark Pair window
are combined into the SSEP Measurement Table window.
Evoked Measurement Table Window

This window is for the SEP, ESCP and ECG-SSEP program.
Number of rejected waveforms

Latency from the trigger
point to the onset mark
Number of averaged waveforms Sensitivity
Preset number of
Stimulation
waveforms to average
rate
Stimulation
intensity
Stimulation
duration
Waveform number
(The waveforms which are
displayed in the wave area
are automatically displayed
in waveform number order.)
Measurement items
No. box

2. Enter an annotation from the keyboard or the annotation list. You can edit the
list in the User Define dialog box.
Annotation column.

waveform
Compare: Calculates the difference between the two values displayed in one
row above and two rows above the selected row.
Setting Pairs
make a pair.
Example Mark Pair From box The mark in the Mark
Pair From box
Type box Mark Pair To box
The mark in the

Mark Pair To box

3-4. CALCULATION
No. box
“A1-B1”.
3
SSEP Measurement Table Window 3-4
This window is for the SSEP program.
Number of rejected waveforms Sensitivity

Stimulation intensity Stimulation settings
Preset number of
Latency from the trigger point to

the onset mark
(When the same mark is set on one
or more waveforms, the latency of
the waveform with the earlier stage is
displayed.)
Calls up the
CSV file
Normative range and

calculation data
CCT (Central Conduction Time)
Type box
Selects measurement items
No. box
Waveform number. When a
measurement item other than
“Interval” is selected, the waveform
number is automatically entered.
Mark Pair From box The marks used for CCT calculation.
Automatically set to the 4th and 5th marks in the latency table
Mark Pair To box
CCT is displayed on the bar.
is displayed when the mark is out
of the normative range.

Displaying Normative Range
When a CSV file is selected in the Normative data file box, the following data is
displayed in the Normative Range (+/−2SD) row.
Normative range (normative value ±2SD)

Mark starting with “N” which is in normative range
Mark starting with “N” which is out of the normative range
Mark starting with other letters, which is in normative range
Mark starting with other letters, which is out of the normative range
To display the calculation value and normative value, set the mouse at the bar,
or .
Creating the CSV File
You can create a normative data file. Using a Microsoft Excel spreadsheet is
recommended. Bars in the NR(+/−2SD) column are displayed based on the
normative data file.
1. Create a new file.
2. Enter text and values. Follow the formats below. Otherwise, the normative
range is not displayed.
- Type the title and comments in the first and second lines.
- Type the normative data in the third or later line.
- The data and sd are 3 digit significant figures, 2 digit decimals. Both the
data and sd must be entered.
Creating the normative data file in an Excel spreadsheet

First line: Title
Second line:
Comment
Third line:
Data and sd for setting Normative value and
the normative range standard deviation of CCT
Bar length in the Normative
Normative value and Normative value and standard
Range (+/−2SD) column
standard deviation of mark 1 deviation of mark 2 on the
on the Labeling page on the Labeling page on the Set
Set Conditions window Conditions window

3-4. CALCULATION
Creating the normative data file as a text file

First line: Title
Second line:
Comment
3
Third line:
Data and sd for setting
the normative range
- The contents are the same as that of the Excel spreadsheet above.
- Words or data must be separated by commas only. Never put a space or tab
before or after a comma.
3-4
3. Save the file in C:\Program files\Npk
Use any file name.
When creating the file in an Excel spreadsheet, select CSV for the file type.
When creating the file with any other software, save the file with .CSV as
the extension in the file name.

Saving Data on Disk
Condition Table Window
The Condition Table window displays the list of settings in which waveforms
were acquired.
To open the Condition Table window, click the Condition Table function button
on the Stop window.
Measurement Condition Processing Examination Patient Gather

Marking Superimpose
Table Table Information Information Wave
F1 F2 F3 F4 F5 F6 F7 F8
Confirm settings for each waveform. Not all settings can be displayed on the
screen at the same time. To display other settings, use the scroll bar or the jump
buttons at the bottom of the screen.
To close the Condition Table window, click the button on the window.

3-4. CALCULATION
You can annotate a measured waveform. The annotation display position and 3
annotation display ON/OFF on the Measurement Table window are set on the
Labeling page of the Set Conditions window. Refer to the MEB-9400 operator’s
manual for details.
1. Click the Marking function button or press the F1 key on the keyboard on
the Stop window.
Measurement Condition Examination Nerve Patient

Marking Processing Superimpose 3-4
Table Table Information Input Information
F1 F2 F3 F4 F5 F6 F7 F8
2. Click the function button on the right of the function buttons.
3. Click the Wave Annotation function button or press the F5 key on the
keyboard to open the Wave Annotation window.

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8
4. Click the or button of the Wave No. box on the Wave Annotation
window to display the waveform to be annotated in the box.
5. Enter an annotation in the Annotation box, or click the button of the

Annotation: box and select an annotation from the drop down list. You can
customize the drop down list. Refer to the MEB-9400 operator’s manual
section 9 “System Settings”.
6. Click the OK button. The added annotation appears on both the selected
waveform on the Wave area and the Annotation column on the Measurement
Table window.
7. Click the Close button. The Wave Annotation window closes.

Section 4 Auditory Evoked Potential

Section 4-2 Measurement – ABR..................................................................................................................... 4.2.1
Section 4-3 Measurement – MLR/SVR............................................................................................................ 4.3.1
Section 4-4 Measurement – EcochG................................................................................................................ 4.4.1
Section 4-5 Calculation..................................................................................................................................... 4.5.1
4-1
4-2
4-3
4-4
4-5

Operation Flow.................................................................................................................................................. 4.1.2

Settings for Each Examination Program.................................................................................................. 4.1.8
Monitoring the Raw Waveforms (Monitor Window)................................................................................ 4.1.12 4
4-1
Waveform (Stop Window)...................................................................................................................... 4.1.15

4. AUDITORY EVOKED POTENTIAL
Operation Flow
Connect electrode leads/cords and auditory stimulator to the system.
Attach the electrodes to the patient.
Attach the auditory stimulator to the patient.

window.

Mark the waveforms for autonomic calculation. Calculate and edit

the acquired waveform and data. The results are displayed in the
Evoked Measurement window.
Save the waveforms and data in the hard disk. 4
4-1


On the Main Menu window, select the examination program. Each program has
Or,
4
4-1

Or,


Category tab



box.

the window.

F1 F2 F3 F4 F5 F6 F7 F8


Before starting measurement, you need to check the measurement settings and
2. Select the condition tab that you want to check. The condition tabs are at the
top of the window.
Condition tab
4-1
manual.

Settings for Each Examination Program

Amp. Page
Item Description
input). You can change the input source to JB or OFF by pressing the Ctrl key
+ F1 to F4 key on the keyboard. The F1 to F4 keys correspond to channels 1 to
4.
to X8 and DIN.
Sens. (/div) Selects the amplifier sensitivity. When “additional amplifier” is set to
“Velocity”, this selects the amplitude of the velocity waveform.
Acquisition Page
Item Description
and average.
Common Reject When a large noise interfered with a Sweep window waveform during
averaging, the affected waveform can be removed from averaging. Common
Reject selects the method to remove the waveform. The limit is set at Reject
Level.
ON: When noise interferes with a sweep waveform acquired from one
channel and the waveform amplitude exceeds the Reject Level, the
waveform and all other sweep waveforms which were simultaneously
acquired from other channels are also removed.
OFF: When noise interferes with a sweep waveform acquired from one
channel and the waveform amplitude exceeds the Reject Level, only
the sweep waveform is removed from averaging.

Trigger Page
Item Description
keyboard.
Auditory Stim Page
Item Description
Waveform Selects the shape of the auditory stimulation signal.
Click: Rectangular shape wave. The duration is set in “Click Duration”.
Burst: Tone burst (modified sine wave). The duration is set in “Plateau
Time”, the rising and falling period is set in “Rise/Fall Time” and the
frequency is set “Tone Freq.”.
Intensity Left Selects the intensity of the left auditory stimulation signal. 4
Intensity Right Selects the intensity of the right auditory stimulation signal.
Stim. Site Left Selects the auditory stimulation site. 4-1
OFF: No stimulation
ON: Left ear
Mask: The white noise for masking is applied to the left ear. The white noise
intensity is the intensity set in “Intensity Right” + the intensity set in
“Mask Level”.
Stim. Site Right Selects the auditory stimulation site.
OFF: No stimulation
ON: Right ear
Mask: The white noise for masking is applied to the right ear. The white
noise intensity is the intensity set in “Intensity Left” + the intensity set
in “Mask Level”.
Mask Level Selects the intensity of the signal output as white noise. The white noise is
applied to the ear which is not examined to mask it from the stimulation.

Labeling Page
Item Description
Auto Mark Check this box to automatically set the mark on the waveform. The marked
position is set in “Mark Position”. Only for the ABR examination program.
Type
Misc. Page
Item Description
Show Intensity Check this box to display the window which displays the stimulation intensity.
Window
Show Measurement Check this box to display the Measurement Table window for each
Window examination program when the examination program opens.
Show Nerve/Muscle Check this box to display the table to enter nerve name or muscle name when
Table the examination program opens.
Right

ABR Page
Item Description
Number of Step Number of steps to perform.
For example, when this item is 6, the system automatically performs steps 1 to
6.
Ch. Select the channel to acquire the waveform from.
Stim. Side Select the side to give stimulation to.
Single ch. Ipsi When this item is checked, the ch. is automatically set as following.
Left side stimulation: Acquire waveform from odd channel
Right side stimulation: Acquire waveform from even channel
Measurement Table Selects either “Routine” or “V wave I-L curve” type of the ABR Measurement
Type II Table Type II.
Ch.: Click the button on the box to display selectable channels. The channels
4
which are set to OFF at Input Select on the Amp. page are not displayed.
When ALL is selected, waveforms from all channels are acquired. 4-1
Single ch. Ipsi: When this item is checked, the Ch. boxes become gray.
Individual setting for each step is not available. The channels
which are set to OFF at Input Select on the Amp. page are not
used.

Four operation modes are used for measurement in this instrument. Select a
operation panel.

Amplifier
sensitivity
Monitoring time


the Monitor window changes to the Sweep window. Evoked waveforms are
displayed on the Sweep window.
Stimulation and acquisition stop and the Sweep window changes to the Stop
window.
Preset number of waveforms Number of acquired waveforms

to acquire
4-1
Sensitivity


the Average window.
Number of rejected
waveforms
Preset number of waveforms
to average
Sensitivity


(Stop Window)
in the hard disk.
Number of acquired or
averaged waveforms
Preset number of waveforms Number of rejected
to acquire or average waveforms
4
4-1

Section 4-2 Measurement – ABR
General.............................................................................................................................................................. 4.2.2
Features.................................................................................................................................................. 4.2.2
Preparation........................................................................................................................................................ 4.2.3
Measurement..................................................................................................................................................... 4.2.6
Measurement Procedure......................................................................................................................... 4.2.6 4
Automatic Measurement Procedure........................................................................................................ 4.2.7
Operations on the Stop Window.............................................................................................................. 4.2.8
4-2
Printing Data........................................................................................................................................... 4.2.8

General
Auditory brainstem response which has a short latency component (within 10

ms) of the auditory evoked potential can be measured with the following features
in the ABR program.
Features
• The factory default setting is: analysis time at 1 ms/div, 2 channel
measurement
displayed on the window (4 channels × 26 stages).
• The response waveform can be marked either automatically or manually.
• Auto marking is available.
• Latency, latency interval, amplitude and acoustic pressure are displayed in the
Measurement Table window.
• The Normative data can be put in the Measurement Table window Type II and
the I-L curve window.
• Auditory threshold can be measured automatically.
• The I-L curve can be displayed in the I-L Curve window.
ABR window

4-2. MEASUREMENT – ABR
Preparation
Electrode Attachment and Connection

1. Connect the recording electrode (disk electrode) leads to the electrode jacks.
3. Connect the headphone cord to the AUDITORY connector on the right side
panel of the main unit.
where the recording electrodes will be attached. Rub the skin with an 4
optimal amount of Skinpure skin preparation gel to reduce artifact. Wipe
the skin thoroughly with dry gauze to remove any moisture and gel from the
skin.
4-2
5. Attach the recording electrodes (active and reference electrodes) and
grounding electrodes to the optimal sites on the patient’s head with paste.
NOTE
7. Put the headphones on the patient.
NOTE
slightly.

Electrode Placement Example

The following derivation is typically used in the ABR measurement.
<ABR at left ear>
Recording electrode placement
Grounding electrode
Active electrode
Stimulating left ear
Reference electrode (−)

JB-944 BK (4 channel, without montage function) BM-911B ABR Extension Cable
Fpz A1
A1 A2 Cz
Fpz
A2
ABR extension cable
Cz

WARNING
applied.
CAUTION 4
4-2




Measurement

and settings.

1. Select the AUDITORY tab in the Category tab on the Main Menu window.
The examination program buttons on the Main Menu window change.
2. Select ABR in the Main Menu window. The ABR examination program
window opens.
waveform from the recording electrode. Confirm that there is no artifact.
2. Press the L/R key on the operation panel to select the stimulating output
side. When the L/R key on the operation panel is pressed, the output changes
as follows. → LEFT → RIGHT → LEFT and RIGHT
The default setting is LEFT.
3. Turn the stimulation intensity dial on the operation panel to increase the
stimulation intensity. The default setting is at 90 dBnHL.


the Set Conditions window, the averaged waveforms are temporarily saved
Automatic Measurement Procedure

The system performs automatic measurement according to the steps set on the
ABR page on the Set Conditions window. For the settings, refer to “Checking
and Changing Measurement Settings” in this section. 4
When temporarily saved data is in memory

When the waveforms of the latest stage saved in memory are acquired with the
same stimulation intensity and stimulation side as one of the steps, automatic 4-2
measurement starts at the step.
waveform from the recording electrode. Confirm that no artifact is
overlapping.
2. Click the Start Auto Seq. function button or press the F8 (Start Auto Seq.)
key on the keyboard.
Measurment Condition Processing Superimpose Examination Patient Start

Marking Auto Seq.
Table Table Information Information
F1 F2 F3 F4 F5 F6 F7 F8
The Start Auto Seq. function button changes to the Stop Auto Seq. function
button.
The system starts acquiring waveforms according to the steps set on the ABR
page on the Set Conditions window. Acquired waveforms are automatically
averaged and temporarily saved in memory.
3. When all steps finish, the window changes to the Stop window.
To quit automatic measurement, click the Stop Auto Seq. function button or
press the F8 (Stop Auto Seq.) key on the keyboard. To continue automatic
measurement from the step where measurement was stopped, click the
Start Auto Seq. function button or press the F8 (Start Auto Seq.) key on the
keyboard.

Operations on the Stop Window

In the Stop window, the following operations are available.
• Deleting waveforms
• Marking
• Saving data on disk
• Printing data
Deleting Waveforms
selected.
Channel button The Channel button is down: All waveforms in one channel are selected.
Selects the channel if the Channel button is
selected.
deletion appears.
Saving Data on Disk

Printing Data

Section 4-3 Measurement – MLR/SVR
General.............................................................................................................................................................. 4.3.2
Features.................................................................................................................................................. 4.3.2
Preparation........................................................................................................................................................ 4.3.3
Measurement..................................................................................................................................................... 4.3.6
Measurement Procedure......................................................................................................................... 4.3.6 4
Printing Data........................................................................................................................................... 4.3.8
4-3

General
MLR: Middle latency response which has middle latency component (10 to 50
ms) of the auditory evoked potential
The factory default setting is analysis time 5 ms/div, 1 channel
measurement.
SVR: Slow vertex response which has long latency component (50 ms or more)
of the auditory evoked potential
The factory default setting is analysis time 50 ms/div, 1 channel
measurement.
Features
window (4 channels × 26 stages).

4-3. MEASUREMENT – MLR/SVR
Preparation

1. Connect the recording electrode (disk electrode) leads to the electrode jacks.
panel of the main unit.
where the recording electrodes will be attached. Rub the skin with an 4
optimal amount of Skinpure skin preparation gel to reduce artifact. Wipe
the skin thoroughly with dry gauze to remove any moisture and gel from the
skin.

grounding electrodes to the optimal sites on the patient’s head with paste. 4-3
NOTE
7. Put the headphones on the patient.
NOTE
slightly.


The following derivation is typically used in MLR/SVR measurement.
<MLR/SVR at left ear>
Grounding electrode
Active electrode
Stimulating left ear

JB-944BK (4 channel, without montage function) BM-911B ABR Extension Cable
Fpz A1
A1 A2 Cz
Fpz
A2
ABR extension cable
Cz

WARNING
applied.
CAUTION 4
4-3




Measurement

and settings.
1. Click the AUDITORY tab in the Category tab on the Main Menu window.
2. Select the MLR or SVR on the Main Menu window. The selected
examination program window opens.
as follows. → LEFT → RIGHT → LEFT and RIGHT


• When Auto Store is OFF, press the Store button on the Tool bar or the
STORE key on the operation panel to save the waveform.

• Marking 4
• Printing data
4-3
Deleting Waveforms
selected.
selected.
deletion appears.

Saving Data on Disk

Printing Data

Section 4-4 Measurement – EcochG
General.............................................................................................................................................................. 4.4.2
Features.................................................................................................................................................. 4.4.2
Preparation........................................................................................................................................................ 4.4.3
Derivation................................................................................................................................................ 4.4.4
Derivation from External Auditory Meatus.................................................................................... 4.4.4
Derivation from Tympanic Membrane............................................................................................ 4.4.4
Derivation from Tympanic Promontory (Intratympanic Derivation)................................................ 4.4.5 4
Measurement ................................................................................................................................................... 4.4.7
Saving Data on Disk................................................................................................................................ 4.4.9 4-4
Printing Data........................................................................................................................................... 4.4.9
AP and CM Classification........................................................................................................................ 4.4.9

General
EcochG measures auditory evoked responses from the cochlear and auditory
nerves by giving sound stimulation to the ear.
Features
• AP (whole nerve Action Potential) and CM (Cochlear Microphonics) can be
automatically classified during averaging (auto processing function).
• The factory default setting is analysis time at 1 ms/div, 2 channel
measurement.

4-4. MEASUREMENT – ECOCHG
Preparation

1. Connect the recording electrode leads to the electrode jacks.
panel of the main unit. When using the electrocochleogram needle electrode
for the recording electrode, use a speaker box instead of the headphone.
4. Attach the recording electrodes (active* and reference electrodes) and 4

grounding electrodes to the optimal sites.
* Refer to each derivation on the next page.
WARNING
Attach the electrodes under the supervision of a physician in charge.
4-4
CAUTION
5. Put the headphones on the patient or place a specified speaker box near the
patient’s ear.
NOTE
slightly.
• When using the YZ-0073 silver ball electrode, refer to the YZ-0073 silver
ball electrode manual.

Example:
<When using the YZ-0073 silver ball electrode>
CH1 (−)
Shield wire
CH1 (+) Silver ball
electrode
Disk electrode

JB-944 BK (4 channel, without montage function)
Reference electrode
(Stimulation side earlobe)
Grounding electrode
(Fpz or nasion)
Active electrode
(External auditory meatus)
Derivation
Derivation from External Auditory Meatus
1. Apply topical anesthesia to the external auditory meatus.
2. Clean the meatus with alcohol moistened cotton applicator.
3. Put the silver ball electrode (used as active electrode (−) ) with the ECG/
EEG paste on the meatus.
Derivation from Tympanic Membrane
1. Apply topical anesthesia to the tympanic membrane.
2. Put the silver ball electrode (used as active electrode (−) ) with the ECG/
EEG paste on the tympanic membrane.

Derivation from Tympanic Promontory (Intratympanic Derivation)
CAUTION
NOTE
When using the electrocochleogram needle electrode (purchased locally),
use the specified speaker for the auditory stimulation.
1. Disinfect the external auditory meatus and tympanic membrane and apply
local anesthesia. 4
2. Insert an electrocochleogram needle electrode (used as active electrode (−) )

into the tympanic promontory through the tympanic membrane.
4-4

CAUTION




Measurement

and settings.
1. Click the AUDITORY tab in the Category tab on the Main Menu window.
2. Select EcochG on the Main Menu window. The EcochG examination

program window opens.
4
1. Press the MONITOR key on the operation panel to monitor the raw 4-4
as follows.
→ LEFT → RIGHT → LEFT and RIGHT




On the Stop window, the following operations are available.
• Deleting marks
• Processing the AP (whole nerve action potential) and CM (Cochlear
Microphonics)
• Marking
• Displaying Measurement Table window
• Printing data
Deleting Waveforms
Individual button All button ALL/INDV key: Selects one or more waveforms. The All,
Channel or Individual button on the Tool
bar indicates the selected waveform(s).
selected.
Channel button
SELECT ↓ ↑ key: Selects the stage if the ALL button is
selected. Selects the channel if the Channel
button is selected.
deletion appears.

Saving Data on Disk

Printing Data
AP and CM Classification 4
To measure AP (whole nerve Action Potential) and CM (Cochlear Microphonics)

waveforms, use averaging and subtracting functions.
Refer to the MEB-9400 operator’s manual Section 6 “Processing the Waveform”.
Reference: Data of a normal examinee

<COND> <RARE>
4-4
1 2 3 1 2 3
latency (ms)
stimulus
response
<A> <B>
CM
AP
<A+B> <A−B>

General.............................................................................................................................................................. 4.5.3
Marking.............................................................................................................................................................. 4.5.4
Auto Marking During Acquisition............................................................................................................. 4.5.4
Marking After Acquisition........................................................................................................................ 4.5.4
Setting One Mark at a Time.......................................................................................................... 4.5.4
Setting Multiple Marks Automatically According to the Settings on the Labeling Page................. 4.5.6
Moving a Mark......................................................................................................................................... 4.5.6
Deleting Marks........................................................................................................................................ 4.5.7 4
Measurement Table Windows............................................................................................................................ 4.5.8
Measurement Table Window Type I Description.............................................................................................. 4.5.10
For the MLR, SVR, EcochG Examination Program............................................................................... 4.5.10
Evoked Measurement Table - Latency Window..................................................................................... 4.5.10
Entering Normative Data............................................................................................................. 4.5.10 4-5
Evoked Measurement Table - Mark Pair Window.................................................................................. 4.5.11
Setting Pairs................................................................................................................................ 4.5.12
For the ABR Examination Program....................................................................................................... 4.5.13
ABR Measure Window.......................................................................................................................... 4.5.13
Setting Pairs................................................................................................................................ 4.5.14
Entering Normative Data............................................................................................................. 4.5.14
Measurement Table Window Type II Description............................................................................................. 4.5.15
For the MLR, SVR, EcochG Examination Program............................................................................... 4.5.15
Setting Pairs................................................................................................................................ 4.5.16
For the ABR Examination Program....................................................................................................... 4.5.17
ABR Measurement Table Window......................................................................................................... 4.5.17
Routine........................................................................................................................................ 4.5.17
Laency-Interval-Amp. Table......................................................................................................... 4.5.17
V wave I-L Curve......................................................................................................................... 4.5.18
Latency-Interval-Amp. Table........................................................................................................ 4.5.18
V wave I-L Curve Graph.............................................................................................................. 4.5.19
Diagnosis.................................................................................................................................... 4.5.19
I-L Curve Window............................................................................................................................................ 4.5.20
Displaying the I-L Curve.............................................................................................................. 4.5.20

Creating a Normative Data File................................................................................................... 4.5.21

4-5. CALCULATION
General
In the ABR, MLR, SVR and EcochG examination programs, the following
calculation operations are available.
• Marking
• Annotating waveforms
4-5

Marking
When marks are set on the waveform, the latency and amplitude are calculated.
The calculation values are displayed on the Evoked Measurement Table window.
Auto Marking During Acquisition

This function is only available with the ABR examination program.
When the Auto Mark check box is checked on the Labeling page on the Set
Conditions window, marks are automatically set while waveforms are acquired.
Marking After Acquisition

There are two ways to set marks on the waveform after acquisition.
• Setting multiple marks automatically according to the settings on the Labeling
page on the Set Conditions window
Setting One Mark at a Time
1. Click the Marking function button on the Stop window or press the F1
(Marking) key on the keyboard.

F1 F2 F3 F4 F5 F6 F7 F8

highlighted.
the mark label one line below is highlighted. Up to 12 marks can be set on
one waveform.

operation panel.
marked.

4-5. CALCULATION
3) Click the function button of the mark label you want to set, or press the
function key on the keyboard corresponding to the mark label. The mark is
set on the cursor point. The latency (ms) at the point is displayed under the
selected mark label on the function button.
a) Click the function button or press the F9 key on the keyboard to
display the next function buttons.
mark label with the F2 (Select Prev. Mark) or F3 (Select Next Mark) key
on the keyboard. To select marks listed in the upper Mark Label window, 4
press the F2 key. To select marks listed in the lower Mark Label window,
press the F3 key. The selected mark label is highlighted.
Select Select Auto Wave Delete End

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
c) Click the Add Mark function button or press the F1 (Add Mark) key on
the keyboard. The mark is set at the cursor point.
Select Select Auto Wave Delete End 4-5

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
on the keyboard.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8


the Labeling Page
This function is only available in the ABR examination program.

With the following procedure, marks are automatically set according to the
settings on the Labeling page on the Set Conditions window after waveform
acquisition.
1. Select the waveform to be marked with the SELECT ↓ ↑ key on the

operation panel.
2. On the Stop window, click the Marking function button, or press the F1 key
on the keyboard.

F1 F2 F3 F4 F5 F6 F7 F8
3. Click the function button on the right of the function buttons or press the
F9 function key on the key board.
4. Click the Auto Marking function button or press the F4 key on the keyboard.

Marking Marking
Prev Mark Next Mark Marking Annotation Mark
F1 F2 F3 F4 F5 F6 F7 F8
on the keyboard.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
Moving a Mark
do “Setting a Mark at a Time” procedure. The selected mark move to the new
position.

4-5. CALCULATION
Deleting Marks
When the mark label you want to delete is on the function button, you can also
Or,
4
2. Click the Add Mark function button or press the F1 key on the operation
panel. The mark is deleted.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
Deleting All Marks

4-5
Click the Delete Mark function button or press the F6 key on the keyboard.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8

Measurement Table Windows
There are two types of Evoked Measurement Table windows, Type I and Type
II. Select either Type I or Type II on the Labeling page on the Set Conditions
window.
<Type I>
<For the MLR, SVR, EcochG <For the ABR examination program>
examination programs>
Evoked Measurement Table-Latency window
Evoked Measurement Table-Mark Pair window ABR Measure window

4-5. CALCULATION
<Type II>
<For the MLR, SVR, EcochG examination programs>
<For the ABR examination program>
4-5
ABR Measurement Table window ABR Measurement Table window

(Routine) (V wave I-L curve)

function button.

F1 F2 F3 F4 F5 F6 F7 F8


For the MLR, SVR, EcochG Examination Program

When Type I is selected on the Labeling page on the Set Conditions window, the
Evoked Measurement Table - Latency window and the Evoked Measurement
Table - Mark Pair window open.

automatically displayed in wave number order.
Latency: Latency from the trigger point to the onset mark.
You can enter normative data in a box.

1. Click the Show ND check box on the Evoked Measurement Table-Latency
window. The two rows of the Normative data columns appear.
2. Click the column in which you want to enter data. The cursor moves to the
clicked column. Enter normative data where the cursor is blinking. The
entered data remains in the next measurement.

4-5. CALCULATION

To open the annotation list, click the on the right of the Annotation
column.
You can also annotate a waveform on the Wave Annotation window. Refer to the
“Annotating a Waveform” in this section.

4
Type box
No. box
4-5
Click the arrow button of the Type box. The selectable items are displayed in the
drop down list. Items are Interval, Amplitude, Compare and (none).

waveform. When the same mark labels are selected, this item shows
the amplitude from the baseline.
Compare: Calculates the difference between the two values displayed in the
two rows above.

Setting Pairs
make a pair.
N11
A1
Ep
A3
Calculation value
To enter the waveform number in the No. box, use the keyboard. When you
set two waveform numbers (only for Interval), enter waveform numbers in the
format “A1-B1”.

4-5. CALCULATION
For the ABR Examination Program

ABR Measurement window opens.
ABR Measure Window

4-5

automatically displayed in waveform number order.
Latency: Latency from the trigger point to the onset mark.
Amplitude: Potential difference between the two input marks on the
selected waveform. When the same mark labels are selected,
this item shows the amplitude from the baseline.
Stim.1: Stimulation output (Auditory stimulation output)
I-L Curve button: Press this button to display the I-L curve window. Refer to
“I-L Curve Window”.
Show ND: Displays the normative data column.
Show Interval: Displays the Interval column.
Show Amp.: Displays the Amp. column.

Setting Pairs
make a pair.

II III
I
A1
Calculation value
box, and the Normative Data column appears.
3. Enter the normative data with the keyboard. The entered data remains at the
next measurement.

To open the annotation list, click the button on the right of the Annotation
column.

4-5. CALCULATION
Measurement Table Window Type II Description
When the waveforms are marked, waveform measurement starts and the results
can be displayed in the Evoked Measurement Table window.
For the MLR, SVR, EcochG Examination Program

When the Type II is selected on the Labeling page on the Set Conditions window,
the Evoked Measurement Table window opens.
Evoked Measurement Table Window 4

Latency from the trigger point
Number of rejected waveforms to the onset mark

to average Sensitivity
Stimulation rate
Waveform number
The waveforms
Stimulation
which are displayed 4-5
intensity left
in the wave area are
automatically displayed
in wave number order.
Stimulation
intensity right
(M means mask
noise)
Annotation for each

waveform
Type box:
Selects measurement
items
No. box


To open the annotation list, click the button on the right of the Annotation
column.
drop down list. Items are Interval, Amplitude, Compare and (none).

two rows above.
Setting Pairs
make a pair.
The mark in the Mark
Pair From box
The mark in the Mark

Pair To box

To enter the waveform number in the No. box, use the keyboard.
When you set two waveform numbers (only for Interval), enter waveform
numbers in the box in the format “A1-B1”.

4-5. CALCULATION
For the ABR Examination Program

The Measurement Table window Type II for the ABR examination program has
two types, Routine type and V wave I-L curve type. Select either Routine type or
V wave I-L curve type at the ABR Condition page on the Set Conditions window.
ABR Measurement Table Window

Routine
Stimulation intensity left
Preset number of waveforms Sensitivity Stimulation intensity right
to average
Stimulation rate 4
Stimulation intensity right
(M means mask noise)
I-L Curve button

Opens the I-L Curve
window.
Use the mouse to

enter a mark label. 4-5
Lat.-Interval-Amp. Table
Scroll bar
Sorts the waveforms and data by measurement order,
stimulation intensity or stimulation site.
Latency-Interval-Amp. Table
Latency, latency between marks, and amplitude for each waveform for the
stimulation are calculated. Up to 16 lines are displayed.
You can see all twelve marks in the Latency column by scrolling. When two or
more waveforms are acquired under the same stimulation intensity and side, and
the same mark is set on these waveforms, the latency of the waveform with the
earlier stage is displayed.
For the boxes in the Amp column, you can enter two marks to calculate the
amplitude between the marks. For other columns, items are fixed.

V wave I-L Curve

Preset number of waveforms Sensitivity
to average
Stimulation rate
(M means mask noise)
I-L Curve button

Opens the I-L Curve
window.
Use the keyboard to enter

a mark label.
Lat.-Interval-Amp. Table
Diag List button

Opens the Diag. List.
Diagnosis
V wave I-L curve graph
Sorts the waveforms and data by

measurement order, stimulation intensity or
stimulation site.
Latency-Interval-Amp. Table
Latency, latency between marks, and amplitude for each waveform for the
stimulation are calculated. Up to 16 lines are displayed.
You can see all twelve marks in the Latency column by scrolling. When two or
more waveforms are acquired under the same stimulation intensity and side, and
the same mark is set on these waveforms, the latency of the waveform with the
earlier stage is displayed.
For the boxes in the Amp column, you can enter two marks to calculate the
amplitude between the marks. For other columns, items are fixed.

4-5. CALCULATION
V wave I-L Curve Graph
The I-L curve of the V wave is displayed.
Normative range is displayed as .

: Plot in normative range
: Plot out of normative range
: No mark is set.
Normative data file is set in the I-L Curve window.
I-L Curve window ABR Measurement Table window (V wave I-L curve)
Diagnosis 4-5
In the Diagnosis area, you can enter a diagnosis for ABR.

There are two ways to enter a diagnosis.
• Type from the keyboard.
• Click the Diag List button to open the Diag. List box. Select an item and click
the Copy & Paste button.
The Diag. List can be edited. Refer to the MEB-9400 operator’s manual

I-L Curve Window
Displaying the I-L Curve
The I-L Curve window displays the Intensity-Latency curve (I-L curve) and the
Interpeak Latency curve (IPL curve) for the marked waveforms.
To open the I-L Curve window, click the I-L Curve button on the Evoked
Measurement Table - Latency window or on the ABR Measurement Table
window.
The graphs are automatically displayed. To close the I-L Curve window, click the
Close button on the I-L Curve window.
When a normative data file is selected in the Normative data File box, normative
range is displayed on the graph as .
Latency
I-L curve
Stimulation intensity
IPL curve

4-5. CALCULATION
Creating a Normative Data File
You can create a normative data file. The normative data is displayed on the I-L
curve graph and IPL curve graph. You can compare the graphs and normative
data.
You can enter the data as text in a text file or create the file in a Microsoft Excel
work sheet and save it as a text file in CSV format. Using a Microsoft Excel
work sheet is recommended.
- Type the title and comments in the first and second lines. Type the 4
normative data and sd in the third and later lines.
- Type the data in the order shown in the example below.
- Intensity: maximum 8 lines, 0 to 90 dB in 1 dB step.
- data, sd: 3 digit significant figure, 2 digit decimals
Both the data and sd need to be entered.
- Save the normative data file in C:\Program Files\Npk.

First line: Title
4-5
Second line: Comment
Third line and later lines:

Data and sd for setting the
normative range
Stimulation intensity (dB) Normative value and Normative value and standard
standard deviation of mark 1 deviation of mark 2 on the
on the Labeling page on the Labeling page on the Set
Set Conditions window Conditions window

First line: Title
Second line:
Comment
Third line and later lines:

Data and sd for setting the
normative range

Use any file name.

4-5. CALCULATION
Saving Data on Disk
To save the measurement results and waveforms on the hard disk, refer to the
were acquired. 4
on the Stop window or press the F3 key on the keyboard.

F1 F2 F3 F4 F5 F6 F7 F8
Confirm settings for each waveform. Not all settings can be displayed on the
screen at the same time. To display other settings, use the scroll bar or the jump 4-5

You can annotate a measured waveform. The annotation display position and
manual for details.
the Stop window.

Marking Superimpose
F1 F2 F3 F4 F5 F6 F7 F8
3. Click the Wave Annotation function button or press the F5 (Wave

Annotation) key on the keyboard to open the Wave Annotation window.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8

Table window.

Section 5 Visual Evoked Potential

Section 5-2 Measurement – Pattern VEP/Goggle VEP/Flash VEP.................................................................. 5.2.1
Section 5-3 Measurement – ERG..................................................................................................................... 5.3.1
Section 5-4 Measurement – EOG.................................................................................................................... 5.4.1
5-1
5-2
5-3
5-4
5-5

Operation Flow.................................................................................................................................................. 5.1.2

(Stop Window)....................................................................................................................................... 5.1.15
5-1

5. VISUAL EVOKED POTENTIAL
Operation Flow
Connect electrode leads/cords and visual stimulator to the system.
Attach the electrodes to the patient.
Check the skin-electrode contact impedance. (except ERG

examination)

window.


Evoked Measurement window.
5-1


Or,

Or,

2. Press the SIDE/SET key on the operation panel. 5

Category tab
5-1



box.

the window.
F1 F2 F3 F4 F5 F6 F7 F8


top of the window.
Condition tab
5-1
manual.

Amp. Page
Item Description
to X8 and DIN.
Additional Amplifier Selects the processing when acquiring the waveforms.
OFF: No processing is performed.
Integral: Displays the integral of the acquired waveforms using the reset
threshold which is selected in “Reset”.
Mean: Displays the envelope of the acquired waveforms using the time
constant which is selected in “Time Constant”. When a lower time
constant is selected, a higher resolution waveform envelope appears
(with more slices per time).
Velocity: Displays velocity waveform. When measuring waveform velocity in
the EOG examination program, select Velocity. Sens. shows waveform
velocity.

Acquisition Page
Item Description
and average.
Common Reject When a large noise interfered with a Sweep window waveform during averaging,
the affected waveform can be removed from averaging. Common Reject selects
the method to remove the waveform. The limit is set at Reject Level.
ON: When noise interferes with a sweep waveform acquired from one channel
and the waveform amplitude exceeds the Reject Level, the waveform and
all other sweep waveforms which were simultaneously acquired from
other channels are also removed.
OFF: When noise interferes with a sweep waveform acquired from one channel
and the waveform amplitude exceeds the Reject Level, only the sweep
waveform is removed from averaging.
Trigger Page
Item Description
Trigger Mode Selects the trigger mode.
The default setting for the ERG examination program is EXT1.
EXT 1: Generates a trigger signal synchronized with an external trigger signal
which is input to the TRIGGER IN/OUT connector on the rear panel of
the main unit. 5
keyboard. 5-1
Stimulator Selects the stimulation source.
Set this item as following:
Pattern-VEP examination program Pattern
Goggle-VEP examination program Goggle
Flash-VEP, ERG examination program EXT

Visual Page
Item Description
Pattern Location Selects the location where the pattern is displayed on the CRT monitor for
pattern reversal stimulation.
Pattern Size Selects the size of the pattern displayed on the CRT monitor for pattern reversal
stimulation.
Display Pattern Selects the pattern for pattern reversal stimulation.
Check: Displays the checked pattern on the CRT monitor.
H-Bar: Displays the horizontal bars (stripes) on the CRT monitor.
V-Bar: Displays the vertical bars (stripes) on the CRT monitor.
Display Mode Selects the pattern for the visual stimulation on the CRT monitor.
Reverse: Displays the reversing pattern on the CRT monitor.
(Pattern reversal visual stimulation).
Flash: Displays the flashing pattern on the CRT monitor.
(Flash pattern visual stimulation).
The duration of each flashing pattern is set in “Pattern Display Time”.
Goggle Side Left Check the box to select the visual stimulation site from left, right or both. You
/Goggle Side Right can also change the side with the L/R key on the operation panel.
(area)
The stimulation differs according to the program. Other condition settings are common for these three
programs. Following are the stimulation conditions for each program and the default settings for the items
which need to be set. These settings can be changed on the Visual page of the Set Conditions window. Refer
to the MEB-9400 operator’s manual for details.
Pattern-VEP
Stimulation: Pattern Reversal Stimulation
Stimulation Output: FULL
Pattern Size: 16
The pattern (checker or stripe) reversal or flash stimulation is generated with the connected CRT
display. These items can be set on the Visual page of the Set Conditions window.
• Pattern Location
• Pattern Size
• Display Pattern
• Display Mode
Goggle-VEP
Stimulation: LED Goggle Stimulation
Stimulation Output: BOTH
Flash-VEP
Stimulation: Use external stimulator. Stimulation output synchronizes with the trigger of the
EMG/EP measuring system.

Labeling Page
Item Description
Type
Misc. Page
Item Description
Right
5-1

operation panel.

Monitoring time


Press the STIM/SWEEP key on the operation panel. In Pattern-VEP, Goggle-
VEP and Flash-VEP examination, stimulation starts and the Monitor window
changes to the Sweep window. In ERG and EOG examination, the Sweep
window opens.
window.
Preset number of waveforms to acquire Number of acquired waveforms
Sensitivity
5-1


the Average window.
Number of averaged
waveforms
Number of rejected
waveforms
to average
Sensitivity


(Stop Window)
in the hard disk.

Preset number of waveforms to acquire or average
5-1

Section 5-2 Measurement –
Pattern VEP/Goggle VEP/
Flash VEP
General.............................................................................................................................................................. 5.2.2
Programs................................................................................................................................................. 5.2.2
Features.................................................................................................................................................. 5.2.2
Preparation........................................................................................................................................................ 5.2.4
Stimulator Connection............................................................................................................................. 5.2.4
Pattern/Stripe Reversal CRT Display Stimulation......................................................................... 5.2.4
LED Goggles Stimulation.............................................................................................................. 5.2.4
Stimulator SLS-3100..................................................................................................................... 5.2.5
Visual Angle and Display Placement in Pattern-VEP Program............................................................... 5.2.5
Recommended Display Placement......................................................................................................... 5.2.6
Checking Skin-Electrode Contact Impedance................................................................................................. 5.2.10
Measurement................................................................................................................................................... 5.2.11
Selecting the Program and Changing Measurement Settings.............................................................. 5.2.11
Measurement Procedure....................................................................................................................... 5.2.11
Operations on the Stop Window............................................................................................................ 5.2.12
Deleting Waveforms.............................................................................................................................. 5.2.13 5
Saving Data on Disk.............................................................................................................................. 5.2.13
Printing Data......................................................................................................................................... 5.2.13
5-2

General
WARNING
All stimulation (activation) must be applied under the supervision of
the physician in charge. When the patient has seizure or history of
seizures, visual stimulation may induce seizure activity.
WARNING
Do not apply photic stimulation continuously for more than 5 minutes
in any mode. After applying 5 minutes of photic stimulation to the
patient, wait at least 20 minutes before another photic stimulation.
WARNING
Do not touch the flash lamp assembly because it gets very hot and
can burn skin.
Programs
• Pattern-VEP Visual evoked potential using the pattern/stripe reversal
CRT display*
* Locally available CRT monitor with an analog RGB input
jack.
NOTE
Use an isolation transformer with a CRT monitor.
• Goggle-VEP Visual evoked potential with the LS-102J LED goggles
• Flash-VEP Visual evoked potential with a stimulator
Features
• The factory default setting is analysis time 30 ms/div, 3 channel measurement.

5-2. MEASUREMENT – PATTERN VEP/GOGGLE VEP/FLASH VEP
Pattern-VEP window
5-2

Preparation
Stimulator Connection
CAUTION
Turn off the stimulator power before connecting or disconnecting the
stimulator.
Pattern/Stripe Reversal CRT Display Stimulation
1. Connect the RGB cable provided with the CRT monitor to the D-SUB
connector on the rear of the CRT monitor.
2. Connect the other side of the cable to the PATTERN connector on the right
side panel of the main unit.
D-SUB connector
CRT Monitor
PATTERN connector
LED Goggles Stimulation
Connect the LS-102J cord to the GOGGLE connector on the right side panel of
the main unit.
GOGGLE connector LS102J LED Goggle

Stimulator SLS-3100
Connect the TRIGGER IN/OUT connector on the rear panel of the main unit to
the OUTPUT connector on the rear panel of the stimulator panel SLS-3100 with
the cable (SLS-3100 standard accessory).
Normally set the flashing energy of the SLS-3100 to 0.6 J.

The SLS-3100 stimulates synchronizing with the trigger of the EMG/EP
measuring system.
OUTPUT connector
OUTPUT
FUSE
1A TIME LAG
US
F
E
GND
US
F
E
50 60Hz
100V
TRIGGER IN/OUT connector
Visual Angle and Display Placement in Pattern-VEP Program
Visual Angle
When using the CRT display for pattern reversal stimulation, the visual angle is 5-2
calculated as follows:
360 2 d
r: Horizontal screen size

d: Distance between the display and patient’s eyes
θ: Visual angle to the horizontal screen size
δ: Visual angle to the horizontal length of the black/white square on the screen

Accordingly,
360 r r
57.3
2 d d
δ depends on the Check Size (Number of black/white squares horizontally on the

screen). When the Check Size is 16, δ is 1/16 of θ. When the Check Size is 32, δ
is 1/32 of θ.

D
Check Size
For example,
When the screen size is 17 inch (275 × 350 mm), the relation between the
distance and visual angles (θ and δ) is shown in the following table.
Visual Angle δ Visual Angle δ

Distance δ (m) Visual Angle θ
(Check Size: 16) (Check Size: 32)
1 20.0° 1.25° 0.63°
2 10.0° 0.63° 0.31°
3 6.70° 0.42° 0.21°
Recommended Display Placement

The pattern reversal CRT display should be placed so that the visual angle δ is
approximately 1°.
For example, when the horizontal screen size r is 350 mm and the Check Size
is set to 16 or 32, place the display at 1.25 m or 0.63 m, respectively, from the
patient.


as shown on the next page.
2. Connect the grounding electrode lead to the E jack as shown on the next
page.
where the recording and grounding electrodes will be attached. Rub the skin
with an optimal amount of Skinpure skin preparation gel to reduce artifact.
Wipe the skin thoroughly with dry gauze to remove any moisture and gel
from the skin.

grounding electrodes to the optimal sites on the patient’s head with paste as
shown on the next page.
5. Check skin-electrode contact impedance.
NOTE
6. Connect the stimulator to the corresponding connector on the main unit.

Refer to “Stimulator Connection”.
5
7. Place the monitor at a calculated distance* from the patient so that he/she
faces the monitor.
* Refer to “Visual Angle and Display Placement in Pattern-VEP Program”
and “Recommended Display Placement”. 5-2
8. Make the examination room dim.
NOTE
leads. Hook the electrode leads on the cable tie and fasten them with
tape.
• Have the patient relax on a reclining chair.
• To prevent EMG of the neck, fix the patient’s head with a headrest or a
pillow.
• When using the pattern reversal CRT display in the Pattern-VEP
program, instruct the patient to watch the view target at the center of
the screen without blinking.
• Use an eyepatch to cover the other eye when stimulating only one eye.

<Pattern-VEP measurement>
The following derivations are typically used in the Pattern-VEP measurement.
NOTE
When performing the Pattern-VEP measurement, connect the two
electrode leads used for A1 and A2 with the jumper lead because
A1 + A2 is usually used as the ground electrode in the Pattern-VEP
measurement.
MF
CH1 to 3 Reference electrode (+)
Cz
A1 A2
LO MO RO
Grounding electrode
CH3 Active electrode (–)

Grounding electrode
Example: JB-944BK (4 channel, without montage function)
(−) (+) A1 A2 Cz
CH 1 LO MF
or
CH 2 MO MF jumper lead
CH 3 RO MF LO MO RO
E Cz or A1+A2
jumper lead
jumper lead
MF

<Flash-VEP/Goggle-VEP measurement>
The following derivations are typically used in the Flash-VEP/Goggle-VEP
measurement.
NOTE
When performing the Flash-VEP/Goggle-VEP measurement, select A+
for the Electrode (+) on the Amp page of the Set Conditions window.

CH 1 to 4 Reference electrode (+)
Fz Grounding electrode
Cz
A2
CH 1 to 4 Reference electrode (+)
A1
LO RO
MO
CH 4 Active electrode (–)

Fz
(−) (+)
LO MO RO Cz
CH 1 LO A1+A2
5
CH 2 MO A1+A2
CH 3 RO A1+A2
5-2
CH 4 Cz A1+A2
E Fz
jumper lead jumper lead
jumper lead
A1 A2

WARNING
applied.
CAUTION




Measurement

and settings.

1. Select the VISUAL tab in the Category tab on the Main Menu window. The
2. Select the Pattern-VEP, Goggle-VEP or Flash-VEP examination program in

the Main Menu window. The selected examination program window opens.
5
2. When performing the Pattern-VEP or Goggle-VEP test, press the L/R key on
the operation panel to select the stimulating output side. When the L/R key
on the operation panel is pressed, the output side changes as below.
When performing the Flash-VEP test, go to step 4. 5-2
• Pattern reversal stimulation

→ FULL → LEFT → RIGHT
• LED goggle stimulation

→ LEFT + RIGHT → LEFT → RIGHT
For pattern reversal stimulation, you can change the size of the pattern using
the Intensity dial on the operation panel.

3. Turn the stimulation intensity dial on the operation panel to change the size
of the pattern.
NOTE
There are various patterns for pattern reversal CRT display. Select a
pattern at Pattern Location on the Visual page of the Set Conditions
window. Refer to the MEB-9400 operator’s manual for details.
4. When performing the Goggle-VEP test, attach the LED goggle on the
patient.
When performing the Flash-VEP test, hold the xenon lamp approximately 30
cm from the patient’s eyes.
5. Press the STIM/SWEEP key on the operation panel to start stimulation

output and display the waveforms.
6. Press the ANALYSIS key on the operation panel to start averaging. Artifact
is removed from averaging.

When the averaging reaches the preset value (at Preset Count on the
Acquisition page of the Set Conditions window), the averaging and


• Marking
• Printing data

Deleting Waveforms
ALL/INDV key: Selects one or more waveforms. The All, Channel

Individual button All button
selected.
deletion appears.
5
Saving Data on Disk
5-2
Printing Data

Section 5-3 Measurement – ERG
General.............................................................................................................................................................. 5.3.2
Features.................................................................................................................................................. 5.3.3
Preparation........................................................................................................................................................ 5.3.4
Stimulator Connection............................................................................................................................. 5.3.4
Stimulator SLS-3100..................................................................................................................... 5.3.4
Necessary Accessories/Unit................................................................................................................... 5.3.4
Measurement..................................................................................................................................................... 5.3.7
Printing Data........................................................................................................................................... 5.3.8
5-3

General
WARNING
Apply the contact lens electrode to the patient’s eye under dark red
lighting supervised by a physician. When attaching a contact lens
electrode, follow the contact lens electrode operator’s manual.
WARNING
Remove the contact lens electrode from the patient’s eye after
approximately every 45 minutes and give the patient a 10 minute
rest. If the electrode is applied for more than 45 minutes, it causes a
lack of oxygen to the cornea.
WARNING
applied.
Electroretinogram can be measured in the ERG program by single-flashing the

xenon lamp in front of the patient’s eyes and deriving the potential difference
elicited on the retina to the instrument window through the contact lens
electrode.

5-3. MEASUREMENT – ERG
Features
window (4 channels × 26 stages).
ERG window
5-3

Preparation
Stimulator Connection
CAUTION
Turn off the stimulator power before connecting or disconnecting the
stimulator.
Stimulator SLS-3100
Connect the TRIGGER IN/OUT connector on the rear panel of the main unit to
the OUTPUT connector of the rear panel of the SLS-3100 with the cable (SLS-
3100 standard accessory).
OUTPUT connector
OUTPUT
FUSE
1A TIME LAG
US
F
E
GND
US
F
E
50 60Hz
100V
TRIGGER IN/OUT connector
Normally, set the flashing energy of the SLS-3100 to 20 or 40J.

The waveforms synchronize with the trigger of SLS-3100.
Necessary Accessories/Unit
• Flash stimulator SLS-3100 (option)
• ERG Contact Lens Electrode: KE-L (adult)*
KE-S (child)*
* Not available in the U.S.

WARNING
applied.
1. Connect each contact lens electrode lead with the DIN conversion connector
to the electrode jack as shown on the next page.
2. Connect the reference electrode lead to the electrode jack as shown on the
next page.
3. Connect the grounding electrode lead to the E jack as shown on the next
page.
4. Keep the patient in a dark room and cover the patient’s eyes with an
eyepatch for about 10 minutes for sufficient dark adaptation.
where the reference and grounding electrodes will be attached. Rub the skin
with an optimal amount of Skinpure skin preparation gel to reduce artifact.
5
Wipe the skin thoroughly with dry gauze to remove any moisture and the gel
from the skin.
6. Attach the reference electrode and the grounding electrode to the sites as
shown on the next page. To avoid artifact, cover the reference electrode with
a black tape. 5-3
7. Attach the contact lens electrode to the patient following the procedure
below.
1) Put a few drops of surface anesthetic such as Benoxil in the patient’s
eyes.
2) Put a drop of cornea protecting agent such as Scopisol on the inside
curved portion of the contact lens.
3) Insert the lower edge of the contact lens to the patient’s lower eyelid
pulling the eyelid down.
4) Insert the upper edge of the contact lens to the upper eyelid pulling the
upper eyelid up.

NOTE
tape.
• Have the patient relax on a reclining chair or bed with his/her eyes
relaxed and not focused.
• Ask the patient to look at the little LED of the flash stimulator without
blinking.
Example:

CH1, 2 Reference electrode ( ) (Fpz)
CH1 Active electrode (+) (ERG contact lens electrode)
CH2 Active electrode (+) (ERG contact lens electrode)
30 cm
Grounding electrode (on earlobe)

Fpz
A2
jumper lead
left eye right eye

Measurement

and settings.
2. Select the ERG examination program in the Main Menu window. The ERG
WARNING
When the monitored waveform is abnormal (for example, the
waveform is flat or hum is overlapping), remove the contact lens
electrode from the patient immediately.
5
2. Press the STIM/SWEEP key on the operation panel to open the Sweep
window. 5-3
3. Press the MONITOR key again. The Check Monitor window appears.
4. After confirming that the waveform on the Check Monitor window is stable,
press the FLASH switch on the SLS-3100 to give a single-flash stimulation.
The waveform synchronized with the flash stimulation appears on the Sweep
window.
5. Press the STOP key on the operation panel. The evoked waveform appears
on the Stop window.

• When Auto Store is set to ON (default setting: ON) on the Misc. page
of the Set Conditions window, the waveforms are temporarily saved in
memory when measurement finishes.
the STORE key on the operation panel or press the foot switch which is set
to Store on the Misc. page of the Set Conditions window.


• Marking
• Printing data
Deleting Waveforms
selected.
Channel button
deletion appears.
Saving Data on Disk

Printing Data

Section 5-4 Measurement – EOG
General.............................................................................................................................................................. 5.4.2
Features.................................................................................................................................................. 5.4.2
Preparation........................................................................................................................................................ 5.4.3
Necessary Unit........................................................................................................................................ 5.4.3
Measurement..................................................................................................................................................... 5.4.5
Measuring Velocity Waveforms................................................................................................................ 5.4.6
Deleting Sites.......................................................................................................................................... 5.4.7
Printing Data........................................................................................................................................... 5.4.7
5-4

General
The electrooculogram is the variation of the eyeball static potential derived from
both the lateral and medial canthi by tracing a view target of the view target
reciprocating motion unit such as the SLE-5100 with the head immobilized.
Features
• The velocity waveforms of the nystagmogram on the odd number channels can
be displayed on the even number channels.
• Response waveforms of up to 99 measurements (sites) can be temporarily
saved in memory and reviewed.
EOG window

5-4. MEASUREMENT – EOG
Preparation
Necessary Unit
Nystagmo stimulator SLE-5100: Used for inducing eyeball movement

as shown below.
2. Connect the grounding electrode lead to the E jack as shown below.
where the electrodes will be attached. Rub the skin with an optimal amount
of Skinpure skin preparation gel to reduce artifact. Wipe the skin thoroughly
with dry gauze to remove any moisture and gel from the skin.
4. Attach the recording and grounding electrodes to the optimal sites on the
patient’s head with paste as shown below.
NOTE 5
• The skin-electrode contact impedance should be 5 kΩ or less.
tape.
• Have the patient relax on a chair and place his/her head on a head
fastening stand.
5-4
• Ask the patient to relax his/her eye muscles.
• Perform the examination in a dark room.
Recording electrode placement Electrode lead connection

JB-944 BK (4 channel, without montage function)
Fpz
Grounding electrode right eye left
left eye left
CH1 Electrode (−)
CH2 Electrode (+)
Fpz
CH2 Electrode (−)

CH1 Electrode (+)
left eye right

right eye right

WARNING
applied.
CAUTION




Measurement
Refer to the MEB-9400 operator’s manual if necessary to prepare the equipment

and settings.

2. Select the EOG program on the Main Menu window. The EOG examination
program window opens.
to check or change the measurement settings. Refer to the MEB-9400
operator’s manual for details.
To display the velocity waveform, refer to the page “Measuring Velocity

Waveforms”.
1. Press the MONITOR key on the operation panel to monitor the raw 5
waveform from the recording electrode.
2. After checking that there is no artifact, press the STOP key on the operation
panel.
3. Ask the patient to follow the view target of the SLE-5100.

5-4
4. Press the MONITOR key to acquire the nystagmo waveforms.
5. Press the STOP key on the operation panel to finish measurement.
6. If you want to save the waveforms during measurement, click the Store
button on the Tool bar or press the STORE key on the operation panel. The
preset period of the acquired waveforms before clicking the Store button or
pressing the STORE key are temporarily saved in memory. (The period is set
on the Store Time on the Acquisition page of the Set Conditions window.)
After saving, measurement continues.

7. Press the STOP key on the operation panel to stop measurement and save the
waveforms.
the Set Conditions window, the preset period of the acquired waveforms
before pressing the STOP key are temporarily saved in memory. (The
period is set on the Store Time on the Acquisition page of the Set
Conditions window.)
• When Auto Store is OFF, click the Store button or press the STORE key to
save the waveform.
Site No. box
The term “site” means the saved measurement result and one saved
measurement result is one site. Up to 99 sites can be temporarily saved in
memory. The Site No. box on the examination window shows the current
site.
8. Enter the site information.

1) Click the Site Information function button or press the F8 key on the
operation panel to open the Site Information dialog box.
Append to Show Superimpose Cascade Examination Patient Site

Saved Waves Saved Screen Display Information Information Information
F1 F2 F3 F4 F5 F6 F7 F8
2) Enter the site information in the Site: box by the procedure below.
• From the keyboard, type the site information.
• Click the button and select a site information from the drop down
list. You can define the drop down list. Refer to the MEB-9400
operator’s manual section 9 “System Settings”.
Measuring Velocity Waveforms

To measure velocity waveforms, set Additional Amplifier to Velocity on the Amp
page of the Set Conditions window and perform measurement. When Velocity is
selected, Sens. on the Amp page of the Set Conditions window is the sensitivity
of the velocity waveform.


• Marking
• Printing data
Deleting Sites
An unnecessary site can be deleted.
1. On the Stop window, select the site you want to delete by clicking the or
button at the right of the Site No. box. The temporarily saved waveforms
for the selected site are displayed.
2. Press the ERASE key on the operation panel. A message confirming deletion
appears.
3. Check that the site selection is correct, and press the ERASE key. The
selected site is deleted.
Saving Data on Disk

5
Printing Data
5-4

General.............................................................................................................................................................. 5.5.2
Copying Waveforms to the Saved Waves Window............................................................................................. 5.5.3
Deleting All Waveforms and Measurement Results................................................................................ 5.5.4
Marking.............................................................................................................................................................. 5.5.5
Manual Marking....................................................................................................................................... 5.5.5
Moving a Mark......................................................................................................................................... 5.5.7
Deleting Marks........................................................................................................................................ 5.5.7
To Open the Evoked Measurement Table Window.................................................................................. 5.5.8
To Close the Evoked Measurement Table Window.................................................................................. 5.5.8
Evoked Measurement Table - Latency Window....................................................................................... 5.5.9
Entering Normative Data............................................................................................................... 5.5.9
Evoked Measurement Table-Mark Pair Window.................................................................................... 5.5.10
Setting Pairs................................................................................................................................ 5.5.11 5
Evoked Measurement Table Window Type II Description................................................................................ 5.5.12
Setting Pairs................................................................................................................................ 5.5.13
5-5

General
For Pattern-VEP, Goggle-VEP, Flash-VEP, ERG and EOG, the following

operations are available.
• Marking
Only for EOG examination program, before the above operations, you need to
copy temporarily saved waveform to the Saved Waves window.

5-5. CALCULATION
Copying Waveforms to the Saved Waves Window
In the EOG program, marking, waveform calculation and processing are

performed on the Saved Waves window. Therefore, for these operations, first you
need to call up and display the temporarily saved raw or sweep waveforms on the
Saved Waves window.
1. On the Stop window, select a site by clicking the or button at the right
of the Site No. box. The temporarily saved waveforms for the selected site
are displayed.
2. Select the waveforms on the Stop window with the ALL/INDV key and
SELECT ↓ ↑ key on the operation panel or mouse. The selected waveforms
have a different color. You can also select the waveform(s) by clicking the
All, Channel or Individual button on the Tool bar.
selected.
SELECT ↓ ↑ key: Selects the stage if the ALL button is selected. 5
selected.
3. Click the Append to Saved Screen function button or press the F1 key on
the keyboard. The number in Free count at the lower right of the window
decreases.
Append to Show Cascade Examination Patient Site

Superimpose
Saved Screen Saved Screen Display Information Information Information
F1 F2 F3 F4 F5 F6 F7 F8 F9
5-5

4. Click the Show Saved Screen function button or press the F2 key on the
keyboard. The Saved Waves window appears and the waveform which was
saved in step 3 is displayed.

Superimpose
F1 F2 F3 F4 F5 F6 F7 F8 F9
Deleting All Waveforms and Measurement Results

This function is only available for the EOG examination program. You can
delete all the waveforms and measurement results that are temporarily saved in
memory.
1. Click the function button or press the F9 key on the keyboard on the Stop
window. The next function buttons are displayed.

Superimpose
F1 F2 F3 F4 F5 F6 F7 F8 F9
2. Click the Erase All function button or press the F8 key on the keyboard. The
confirmation message window appears.
Erase
All
F8 F9
3. Click the Yes button. All waveforms and measurement results are deleted.
To cancel deletion, click the Cancel button on the message window. The
message window closes.

5-5. CALCULATION
Marking
You can manually set marks.
Manual Marking

F1 F2 F3 F4 F5 F6 F7 F8
Vertical cursor Latency window Mark Label window
5-5


highlighted.
waveform.

operation panel.
marked.
on the keyboard. To select marks listed in the upper Mark Label window,

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8
cursor point.

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8
on the keyboard.

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8

5-5. CALCULATION
Moving a Mark
do the “Manual Marking” procedure. The selected mark moves to the new
position.
Deleting Marks
• Or,
5
2. Click the Add Mark function button or press the F1 key on the keyboard.

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8
Deleting All Marks

5-5

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8

Type II: The Evoked Measurement Table - Latency window and the Evoked
Measurement Table - Mark Pair window are combined into one table
window.
Type I Type II
Evoked Measurement Table - Latency Evoked Measurement Table window

window
Evoked Measurement Table - Mark Pair window
To Open the Evoked Measurement Table Window

function button.

F1 F2 F3 F4 F5 F6 F7 F8
To Close the Evoked Measurement Table Window


5-5. CALCULATION
When the Type I is selected on the Labeling page on the Set Conditions window,
the following windows open.
When the waveforms are marked, waveform calculation starts automatically and
the results can be displayed in the Evoked Measurement Table window.

Normative data area

5
automatically displayed on the Evoked Measurement Table-
Latency window in waveform number order.
Stim.1, Stim.2: Stimulation output (electrical stimulation output)
Stim.2 is displayed only for the data measured with other
model instruments. 5-5
Show ND check box:
To show the normative data area, check this box.
1. To display the Normative Data area, click the Show ND check box on the
box, and the Normative Data area appears.
2. Click the box to enter the normative data. The cursor appears in the selected
box.
3. Enter the normative data with the keyboard. The data is saved for the next
measurement.


Annotation column.
Evoked Measurement Table-Mark Pair Window

Type box
waveform
two rows above the selected row.

5-5. CALCULATION
Setting Pairs
make a pair.
Example
Type box Mark Pair From box Mark Pair To box
N75 The mark in the mark Pair To box
P100
5
Calculation value
“A1-B1”.
5-5
No. box

Evoked Measurement Table Window Type II Description
When the Type II is selected on the Labeling page on the Set Conditions window,
the Evoked Measurement Table window is displayed. The Evoked Measurement
Table - Latency window and the Evoked Measurement Table - Mark Pair
window are combined into the Evoked Measurement Table window.
Evoked Measurement Table Window

Preset number of waveforms to Number of rejected waveforms Stimulation rate

acquire or average
Sensitivity Stimulation intensity
Waveform number
The waveforms
which are displayed
in the wave area are
displayed in waveform
number order.
Annotation for each

waveform
Selects
Measurement Items
No. box
Enter the waveform
number

5-5. CALCULATION
Annotation column.


waveform.
Area: Area between the two input marks on the selected waveform.
two rows above.
row is displayed, calculation cannot be done. 5
Setting Pairs
make a pair.
labels are displayed in the drop down list. Click the desired mark label. The mark 5-5

Example
N75 The mark in the mark Pair To box
P100
Type box
Calculation value

“A1-B1”.

Saving Data on Disk
were acquired.
or press the F3 key on the keyboard on the Stop window.

F1 F2 F3 F4 F5 F6 F7 F8
Check settings for each waveform. Not all settings can be displayed on the

5-5. CALCULATION
manual for details.
the Stop window.

F1 F2 F3 F4 F5 F6 F7 F8

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8
5-5
Table window.

Section 6 EMG

Section 6-2 Measurement – EMG.................................................................................................................... 6.2.1
6-1
6-2
6-3

Operation Flow.................................................................................................................................................. 6.1.2

Starting Acquisition............................................................................................................................... 6.1.13
Waveform (Stop Window)...................................................................................................................... 6.1.15
6-1

6. EMG
Operation Flow
Connect the electrode leads/cords to the appropriate instrument.
Acquire waveforms. Use the Monitor window.
Stop acquiring waveforms.
Temporarily save the acquired waveforms in memory.
Mark the waveforms in the Stop window. Measure and edit the
acquired waveforms and data. The result is displayed in the
Save waveforms and calculate data in the hard disk.

3. Enter the patient information such as ID No. Name, etc. For details, refer to
4. Click the OK button to close the Patient Information dialog box. 6
6-1

6. EMG
Or,

Or,

Category tab



box.

the window.
F1 F2 F3 F4 F5 F6 F7 F8

Measurement menu → Display Table → Examination Information.

6
6-1

6. EMG
top of the window.
Condition tab
manual.
EMG Page

Item Description
EMG filter Sets the low and high cut values of the amplifier when the EMG filter function
button is pressed.
Lo-cut: low cut filter
High-cut: high cut filter
EMG Measurement Sets whether time (ms) or ratio (mV/ms) is displayed for “Rise Time” in the
(Rise) MUP Analysis window.
Turn Level Sets the amplitude threshold for counting turns.
Phase Level Sets the + and − threshold from the baseline for counting phases.
Findings Window Selects the types of the EMG Findings window (vertical or horizontal).
Monitor Function Key Different measurement settings can be assigned to the function buttons 1 to 3.
F1 to F3: Type the label according to the measurement setting.
F2, F3 Settings: Selects the sweep time and sensitivity. When the F1 function
button is pressed, the settings are returned to the settings set in
the Set Conditions window - Amp page and Acquisition page.
Auto Store: Check this box to automatically save the displayed waveform.
Muscle List Auto Advance: Automatically selects the next muscle name when the
waveforms are saved (STORE key is pressed).
Edit List: Opens the Muscle List dialog box to edit the muscle names for
each EMG measurement program.
EMG filter
When satellite potential is in the waveform and main MUP
components cannot be recognized clearly, EMG filter
temporarily eliminates satellite potential.
Rise Time
90%
Rise time is the time interval between 10 and 90% (peak to
Process amplitude peak) of the fastest up-going process which is also greater
MUP amplitude than 50% of the MUP amplitude
10%
Rise time
2 Turn Level
4
1 Turns is the number of peaks in which the amplitudes of
the rising and falling components both exceed the turn
amplitude threshold.
6
3
5
6-1
Phase Level
PHASE LEVEL
+ Phases is one plus the total number of MUP components
that exceed both thresholds.
1 2 3
0
3 + 1 = 4 phases

6. EMG
Amp. Page
Item Description
Additional Amplifier Selects the processing when acquiring the waveforms.
OFF: No processing is performed.
Integral: Displays the integral of the acquired waveforms using the reset
threshold which is selected in “Reset”.
Mean: Displays the envelope of the acquired waveforms using the time
constant which is selected in “Time Constant”. When a lower time
constant is selected, a higher resolution waveform envelope appears
(with more slices per time).
Velocity: Displays velocity waveform.
Rectify Selects the rectification mode. (see the figure below)
OFF: No rectification.
HALF: Half-wave rectification
FULL: Full-wave rectification
HALF
Raw waveform
FULL
Acquisition Page
Item Description
Sampling time Selects the sampling time.
Monitor (/div) Selects the sweep time for the Monitor window for horizontal 1 div
and average.

Trigger Page
Item Description
Measured Signal Selects the trigger level and trigger point.
Trigger OFF: Acquires the preset period of the raw waveform as a sweep wave
when the raw waveform exceeds a trigger level cursor.
Window: Acquires the preset period of the raw waveform when the raw
waveform exceeds the LEVEL 1 cursor but does not exceed the
LEVEL 2 cursor.
Rise Time: Acquires the raw waveform when the raw waveform exceeds a
trigger level and the Rise Time (the time interval between 10 and
90% (peak to peak) of the raw waveform) is less than “Rise Time
Threshold”.
Rise Time Threshold Selects the time interval when “Measured Signal Trigger” is set to “Rise Time”.
Rise Time Threshold
OFF
Waveforms 1 and 2 are acquired.
LEVEL
TRIGGER OUTPUTsignal
Window
Only waveform 1 is acquired.
LEVEL 2
LEVEL 1
TRIGGER OUTPUT signal 6-1

6. EMG
Rise Time
When “Rise Time 1” < “Rise Time Threshold” < “Rise Time 2”, only waveform
1 is acquired.
Rise Time 1 Rise Time 2
LEVEL
TRIGGER OUTPUT signal
Display Page
Item Description
Cascade Display Check this box to display cascaded waveforms on the Monitor, Sweep and Stop
windows.
Traces per Field Selects the number of waveforms displayed on one screen.
Labeling Page
Item Description
Area Calculation Mode Selects the area calculation mode. (see the figure below)
Baseline: Calculate the area bounded by the waveform, the baseline and the
vertical lines from the two marks (L1 and L2) to the baseline.
Mark: Calculates the area bounded by the waveform and the line between the
two marks (L1 and L2).
Type
Baseline: Calculates the area bounded by the waveform, the baseline and the
Mark: Calculates the area bounded by the waveform and the line between
the two marks (L1 and L2).

Misc. Page
Item Description
Right
6-1

6. EMG
operation panel.

Operation status
High-cut/Low-cut
filter settings
Selected side
Muscle name list
Monitoring time/
Site No./Muscle name/Examination side Foot switch functions

Starting Acquisition
Press the STIM/SWEEP key on the operation panel. The Monitor window
changes to the Sweep window, and the Trigger Level Monitoring window opens.
In the Trigger Level Monitoring window, you can set the trigger level to acquire
waveforms. When the raw waveform exceeds the trigger level, a preset period of
the raw waveform before and/or after the trigger point is displayed on the Sweep
window and temporarily saved in memory. You can set the number of waveforms
to acquire.
Acquisition stops and the Sweep window changes to the Stop window.
Trigger Level Monitoring window
6-1

6. EMG

the Average window.


(Stop Window)
acquisition or averaging stops. The latest raw, acquired or averaged waveforms
are displayed on the Stop window and you can measure the waveforms or save
them in the hard disk.
6-1

Section 6-2 Measurement – EMG
General.............................................................................................................................................................. 6.2.2
Preparation........................................................................................................................................................ 6.2.3
Measurement..................................................................................................................................................... 6.2.4
Waveform Acquisition for EMG Measurement......................................................................................... 6.2.4
Operations on the Stop Window.................................................................................................... 6.2.5
Waveform Acquisition for MUP Measurement......................................................................................... 6.2.6
Operations on the Stop Window.................................................................................................... 6.2.8
Calling up Temporarily Saved Waveforms............................................................................................... 6.2.9
Selecting the Site No. to Display Waveforms on the Stop Window............................................... 6.2.9
Deleting Sites.......................................................................................................................................... 6.2.9
Printing Data........................................................................................................................................... 6.2.9
6-2

6. EMG
General
Program
EMG: Measurement of voluntary/spontaneous EMG
Features
• The factory default setting is analysis time 10 ms/div, 1 channel measurement.
• A single MUP can be recorded by triggered sweeping of the waveform.
• Waveforms can be rectified and integrated in real time.
• Up to 99 waveforms of 600 seconds can be temporarily saved in memory.
EMG Stop window

6-2. MEASUREMENT – EMG
Preparation
WARNING
after use.

1. Connect a fully sterilized needle electrode (concentric needle electrode) to
the extension cable.
2. Connect the extension cable to an electrode lead jack as shown below.
3. Connect the grounding electrode lead to the E jack as shown below.
where the grounding electrode will be attached. Rub the skin with an optimal
amount of Skinpure skin preparation gel to reduce artifact. Wipe the skin
thoroughly with dry gauze to remove any moisture and gel from the skin.
5. Attach the grounding electrode to the optimal sites with paste as shown
below.
NOTE
• In the EMG examination program, the skin-electrode contact impedance
check is not available.
junction box more than 1 m away from the system.
• Have the patient relax and not contract the muscle.
Electrode Connection
6
Grounding electrode
6-2
Needle electrode

6. EMG
Measurement

and settings.
1. Select the EMG tab in the Category tab on the Main Menu window. The
2. Select the EMG examination program on the Main Menu window. The EMG
Side button 4. Enter the muscle name and the examination side.
• To enter the muscle name, click the muscle name in the muscle name list,
or press the MUSCLE/TEST ↑ ↓ key on the operation panel or select the
Muscle name list muscle name by clicking the F5 Muscle List DOWN or F6 Muscle List UP
function button. The selected muscle name is surrounded by a rectangle.
You can enter the desired muscle name in the Other Muscle text box.
• To select the examination side, click the L, R or Both side button or click
the F7 Left, Right or Both function button, or press the SIDE/SET key on
the operation panel.
Manual EMG Findings Muscle List Muscle List Cascade

Right
MUP Findings Summary DOWN UP Display
F1 F2 F3 F4 F5 F6 F7 F8 F9
Other Muscle
text box When the waveform acquisition is started, the muscle name and examination
side are displayed on the title bar and lower right corner of the screen.
Waveform Acquisition for EMG Measurement

waveform. The Monitor window opens and displays the raw waveform.
2. Adjust the volume of the speaker with the Sound volume dial on the
operation panel.
3. Disinfect the patient’s skin at the examined site with a piece of cotton
moistened with alcohol.
4. Insert the EMG needle electrode into the examined muscle.

With the patient’s cooperation, adjust the needle electrode position in the
examined muscle.
5. With the Monitor window and monitor speaker sound, monitor the EMG
of the fully relaxed potential and the voluntary contraction action potential
waveform.

• To adjust the sensitivity to display the waveform of the optimal size, press
the VERTICAL RANGE ↑ ↓ key.
• To adjust the time per division in continuous waveform, press the TIME
SCALE ← → key.
• To change the sweep time and sensitivity combination that is selected on
the Set Conditions window, use the F1 to F3 function keys.
• To display the waveform cascaded, click the Cascade Display function
button.
• To scroll the waveform vertically, turn the WAVE dial on the operation
panel.
• Turn the EMG filter ON or OFF with the EMG Filter function button.
6. Temporarily save the waveform. After you save the waveform, you can
either continue or stop measurement.
To save waveforms and continue measurement

Click the Store button on the Tool bar or press the STORE key on the
operation panel during measurement. The waveform of the set time before
the Store button is clicked ore the STORE key is pressed is saved in
memory. The time is set at Store Time on the Acquisition page of the Set
Conditions window.
Then the next waveform appears on the next site window.
To save waveforms and stop measurement

1) Press the STOP key when a desired waveform appears. The waveform
of the set time before the STOP key is pressed is displayed on the
window. (The time is set at Store Time on the Acquisition page of the
Set Conditions window.)
2) When Auto Store is set to ON (default setting: ON) on the Misc. page
of the Set Conditions window, waveforms are automatically saved in
memory temporarily.
When the Auto Store is set to OFF, click the Store button or the STORE
key to save the waveforms temporarily in memory.
Up to 99 waveforms (site data) can be saved in memory. The number of

currently saved waveforms is displayed in the Site No.: box on the upper
right of the window.
Operations on the Stop Window 6

• Calling up temporarily saved waveforms
6-2
• Copying waveforms to the Saved Waves window
• Marking
• Displaying the EMG Measurement Table window
• Displaying the Manual MUP window. Refer to “Calculation in the Manual
MUP Window”. Duration, Amplitude, Phases, Turns, Area and Rise of the
selected waveform are automatically calculated.
• Making an EMG Findings window
• Deleting all waveforms and measurement results
• Saving site waveforms and measurement data on disk
• Printing
6. EMG
Waveform Acquisition for MUP Measurement

waveform. The Monitor window opens and displays the raw waveforms.
2. Adjust the volume of the speaker with the Sound volume dial on the
operation panel.
3. Disinfect the patient’s skin at the examination site with a piece of cotton
moistened with alcohol.
4. Insert the EMG needle electrode into the examined muscle. With the
patient’s cooperation, monitor the EMG of the moderate contraction action
potential waveform.
the VERTICAL RANGE ↑ ↓ key on the operation panel.
SCALE ← → key.
button.
panel.
• To select the muscle name, click the muscle name in the muscle list or use
the F5 Muscle List UP or F6 Muscle List DOWN function button.
• To select the examination side, click the L, R or Both side button or use
the F7 Left, Right or Both function button.
5. Press the STIM/SWEEP key on the operation panel to display the Sweep
window and the Trigger Level Monitoring window.
Trigger Level Monitoring window

6. Turn the Cursor dial on the operation panel to set the trigger level cursor on
the Trigger Level Monitoring window near the peak of the waveform.
When the raw waveform exceeds the trigger level, a preset period of the raw
waveform before and/or after the trigger point is displayed on the Sweep
window.
The number of waveforms to be acquired is set in Preset Count on the

Acquisition page of the Set Conditions window.
Trigger point Trigger level cursor
the VERTICAL RANGE ↑ ↓ key.
SCALE ← → key.
button.
panel.
6
• Turn the EMG filter ON or OFF with the EMG Filter function button.
7. If necessary, press the ANALYSIS key on the operation panel to average the
waveform. When the averaging reaches the preset value (at Preset Count 6-2
on the Acquisition page of the Set Conditions window), the averaging stops
automatically.

6. EMG
8. Temporarily save the waveform. After you save the waveform, you can
either continue or stop measurement.
To save waveforms and continue measurement

Click the Store button on the Tool bar or press the STORE key on the
operation panel during measurement. The waveform of the set time before
the Store button is clicked or the STORE key is pressed is saved in memory.
The time is set at Store Time on the Acquisition page of the Set Conditions
window. Then the next waveform appears on the next site window.
To save waveforms and stop measurement

1) Press the STOP key when a desired waveform appears. The waveform
of the set time before the STOP key is pressed is displayed on the
window. (The time is set at Store Time on the Acquisition page of the
Set Conditions window.)
2) When Auto Store is set to ON (default setting: ON) on the Misc. page
of the Set Conditions window, waveforms are automatically saved in
memory temporarily.
When the Auto Store is set to OFF, click the Store button or press the
STORE key to save the waveforms temporarily in memory.
The number of saved waveforms is displayed in the Site No.: list box on the
upper right of the window.

• Calling up temporarily saved waveforms
• Copying waveforms to the Saved Waves window
• Marking
• Displaying the EMG Measurement Table window
• Deleting all waveforms and measurement results
• Saving site waveforms and measurement data on disk
• Printing

Calling up Temporarily Saved Waveforms

Waveforms which are temporarily saved in memory can be called up and
displayed on the Stop window.
Selecting the Site No. to Display Waveforms on the Stop Window
On the Stop window, click the or button at the right of the [Site No.] to
select and display the desired waveform. To display the next site data, click the
button. To display the previous site data, click the button. The site No. of
the displayed waveform appears on the upper right of the window.
Deleting Sites
An unnecessary site can be deleted.
1. On the Stop window, select the site you want to delete by clicking the or
button at the right of the Site No. box. The temporarily saved waveforms
for the selected site are displayed.
deletion appears.
3. Check that the site selection is correct, and press the ERASE key. The
selected site is deleted.
Saving Data on Disk

Printing Data
6-2

General.............................................................................................................................................................. 6.3.2
Copying Waveforms to the Saved Waves Window............................................................................................. 6.3.3
Marking.............................................................................................................................................................. 6.3.5
Manual Marking....................................................................................................................................... 6.3.5
Moving a Mark......................................................................................................................................... 6.3.7
Deleting Marks........................................................................................................................................ 6.3.7
To Open the EMG Measurement Table Window...................................................................................... 6.3.8
To Close the EMG Measurement Table Window..................................................................................... 6.3.8
Making an EMG Findings Window................................................................................................................... 6.3.13
Making an EMG Findings Summary Table Window............................................................................... 6.3.14
Calculation In the Manual MUP Window......................................................................................................... 6.3.15
Registering the Waveform........................................................................................................... 6.3.15
Deleting Registered Waveforms.................................................................................................. 6.3.15
Deleting All Waveforms and Calculation Results............................................................................................. 6.3.17
6-3

6. EMG
General
In the EMG examination program, the following operations are available for
calculation.
• Copying waveforms on the Stop window to the Saved Waves window.
• Marking

6-3. CALCULATION
Copying Waveforms to the Saved Waves Window
In the EMG program, marking, waveform calculation and processing are

performed on the Saved Waves window. Therefore, for these operations, first you
need to call up and display the temporarily saved raw or sweep waveforms on the
Saved Waves window.
1. On the Stop window, select a site by clicking the or button at the right
of the Site No. box. The temporarily saved waveforms for the selected site
are displayed.
2. Select the waveforms on the Stop window with the ALL/INDV key and
SELECT ↑ ↓ key on the operation panel or mouse. The selected waveforms
have a different color. You can also select the waveform(s) by clicking the
All, Channel or Individual button on the Tool bar.
ALL/INDV key: Selects one or more waveforms. The All, Channel

Individual button All button
selected.
Channel button
SELECT ↑ ↓ key: Selects the stage if the ALL button is selected.
3. Select the function button or press the F9 function key on the keyboard.
4. Click the Append to Stored Wave function button or press the F4 function
key on the keyboard.
Append to Show Erase

Superimpose
Stored Wave Stored Wave All
F1 F2 F3 F4 F5 F6 F7 F8 F9
5. Click the Show Stored Wave function button or press the F5 key on the
keyboard. The Saved Waves window appears and the waveform which was
selected in step 2 is displayed.
6-3
Append to Show Erase
Superimpose
Stored Wave Stored Wave All
F1 F2 F3 F4 F5 F6 F7 F8 F9

6. EMG
Deleting Waveforms
1. Select the waveforms to delete with the ALL/INDV key and SELECT ↑
↓ key on the operation panel or mouse. The selected waveforms have a
different color. You can also select the waveform(s) by clicking the All,
Channel or Individual button on the Tool bar.
selected.
SELECT ↑ ↓ key: Selects the stage if the ALL button is selected.
appears.

6-3. CALCULATION
Marking
Manual Marking

F1 F2 F3 F4 F5 F6 F7 F8
Latency window Vertical cursor
Mark Label
window
6-3

6. EMG

highlighted.
waveform.

1) Select the waveform to be marked with the SELECT ↑ ↓ key on the
operation panel.
marked.

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8
cursor point.

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8
on the keyboard.

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8

6-3. CALCULATION
Moving a Mark
• On the Mark Label window, select the mark label you want to move. Then, do
“Manual Marking” procedure. The selected mark moves to the new position.
Deleting Marks
• Or,

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8
Deleting All Marks

6
Add Mark
F1 F2 F3 F4 F5 F6 F7 F8
6-3

6. EMG
There are two types of EMG Measurement Table windows: Type I and Type II.
Select Type I or Type II on the Labeling page on the Set Conditions window.
Type I: Displays up to 20 calculation results.

Type II: Displays up to 15 calculation results and appears on the right half of
the EMG window. The Waveform window appears on the left half of
the EMG window.
Type I Type II
To Open the EMG Measurement Table Window

function button.

F1 F2 F3 F4 F5 F6 F7 F8
To Close the EMG Measurement Table Window


6-3. CALCULATION
following window opens.
Up to 20 lines of calculation results are displayed.

Muscle: Muscle name
Side: Examination side
Duration: Time between the marks (duration time of the action potential)
Amplitude: Difference between the maximum and minimum potential between
the marks
Phases: The number of phases, determined by counting negative and
positive peaks to and from the baseline in which each consecutive
peak exceeds ± 15 µV (this value is set at Phase Level in the EMG
Measurement box on the EMG page of the Set Conditions window),
equals the number of baseline crossings plus one.
Turns: When two adjacent potentials (a and b) exceed the Turn Level
amplitude (set at Turn Level in the EMG Measurement box on the
EMG page of the Set Conditions window), the peak is counted
6
as one turn. The total count appears in the Turns column in the
window.
b
6-3
a

6. EMG
Area: Area bounded by the waveform and baseline. The negative area is
calculated in positive value.
Rise: This item calculates either time interval or slope according to the setting
at the Rise on the EMG page of the Set Conditions window. When Time
is selected, the time interval between 10 and 90% of the fastest up-going
process which is also greater than 50% of the amplitude is displayed.
When Ratio is selected, the slope between 10 and 90% of the fastest
up-going process which is also greater than 50% of the amplitude is
displayed.
fastest up-going process
90%
amplitude
10%
rise time

6-3. CALCULATION
When Type II is selected on the Labeling page on the Set Conditions window, the
Up to 15 lines of calculation results are displayed. The waveform window is at

the left.
V-range (sensitivity) and STIM Settings box (stimulation settings) are also
displayed.
V-range: Sensitivity
Muscle: Muscle name
Side: Examination side
Dur.: Time between the marks (duration time of the action potential)
Amp.: Difference between the maximum and minimum potential between 6
the marks
Phases: The number of phases, determined by counting negative and
positive peaks to and from the baseline in which each consecutive
peak exceeds ± 15 µV (This value is set at Phase Level in the EMG
Measurement box on the EMG page of the Set Conditions window),
6-3
equals the number of baseline crossings plus one.
Turns: When two adjacent potentials (a and b) exceed the Turn Level
b amplitude (set at Turn Level in the EMG Measurement box on the
a EMG page of the Set Conditions window), the peak is counted
as one turn. The total count appears in the Turns column in the
window.

6. EMG
Area: Area bounded by waveform and the baseline. The negative area
is calculated in positive value.
Rise: This item calculates either time interval or slope according to
the setting at the Rise on the EMG page of the Set Conditions
window. When Time is selected, the time interval between 10
and 90% of the fastest up-going process which is also greater
than 50% of the amplitude is displayed.
When Ratio is selected, the slope between 10 and 90% of the
fastest up-going process which is also greater than 50% of the
amplitude is displayed.
fastest up-going process
90%
amplitude
10%
rise time
STIM settings: Stimulation rate, stimulation intensity and duration time. Only
when using electric stimulation.

6-3. CALCULATION
Making an EMG Findings Window
An EMG Findings window can be created for each site data. The operator’s
desired diagnosis items and the values can be included. Refer to the MEB-9400
When Site No. 1 and 2 are examinations on the same muscle and examined
site, the contents entered in the EMG Findings Site:1 window are automatically
entered in the EMG Findings Site:2 window.
1. Click the Findings function button or press the F6 key on the keyboard to
open the EMG Findings window.
Append to Show Findings Cascade Findings Examination Patient

Superimpose
Saved Screen Saved Screen Summary Display Information Information
F1 F2 F3 F4 F5 F6 F7 F8 F9
You can make the EMG Findings window vertical or horizontal. Select the
type on the EMG page of the Set Conditions window.
2. Do one of the following to enter the muscle name in the Muscle: box.
• Type in the muscle name in the Muscle: box from the keyboard.
• Click the button to display the drop down list box. Click the muscle
name in the list box.
• Click the Muscle List... button to display the list of defined muscles. Click
the muscle name in the list. To make a custom muscle list, refer to the
3. Do one of the following to enter the examined side.

• Type in the examined side in the Side: box from the keyboard.
• Click the button to display the drop down list and click Left or Right. 6
4. Type in a remark of up to 80 characters in the Remarks: box.
5. Do one of the following to enter a diagnosis for each measurement item.

• Type in a diagnosis from the keyboard.
6-3
• Click the button to display the drop down list and click items in the list.
You can enter the diagnosis listed at the top of the list for each
measurement item by clicking the Set button.
The diagnosis items and drop down list can be set as you want. To customize
the diagnosis items and drop down list, refer to the MEB-9400 operator’s
manual.

6. EMG
6. To search for a data file quickly, you can set a key for a file in the Bookmark
check box. Files can be classified as A or B. Click the A or B check box. To
search for a file, refer to the MEB-9400 operator’s manual.
Making an EMG Findings Summary Table Window

You can see a summary of findings on the EMG Findings Summary Table
window. You can also edit the EMG Findings Summary Table. The EMG
Findings Summary Table window and the EMG Findings window are correlated.
Change on one window applies to the other window. When measurements are
performed on one muscle and side and the results are saved with several Site
Nos., only the smallest Site No. is displayed.
To display the EMG Findings Summary Table window, click the Findings
Summary function button or press the F4 key on the keyboard.
Manual EMG Findings Muscle List Muscle List Cascade

Right
MUP Findings Summary DOWN UP Display
F1 F2 F3 F4 F5 F6 F7 F8 F9
Muscle Name/Side EMG finding list

The muscle name and examination side can be edited. Enter the diagnosis for each measurement item.
Set Muscle List Clear Findings

Enters the diagnosis listed at the Opens the Edit Muscle Table Clears all diagnoses.
top of the list for each measurement dialog box.
item.
To change an item in a box, do one of the following.

• Use the keyboard to enter characters.
• Click the column to display the drop down list box, then click an item in the
list box.

6-3. CALCULATION
Calculation in the Manual MUP Window
When a waveform is dragged from the Stop window, Duration, Amplitude,

Phases, Turns, Area and Rise of the selected waveform are automatically
calculated and the result is displayed on the Manual MUP window. Up to four
waveforms for each site can be registered to the Manual MUP window.
Registering the Waveform
1. On the Stop window, select Manual MUP function button with the mouse to
display the Manual MUP window. When the Manual MUP Window check
box is selected in the Set Conditions window - Misc. page, the Manual MUP
window automatically opens when the EMG examination program is started.
2. Drag the waveform from the Stop window. Duration, Amplitude, Phases,
Turns, Area and Rise are automatically calculated and the result is displayed
on the Manual MUP window. The EMG analysis time (/div) can be set in the
Set Conditions window - EMG page.
Deleting Registered Waveforms
1. Click the waveform or calculation result area. The selected waveform is

surrounded by a yellow rectangle.
6-3
2. Click the Erase button on the Tool bar. The confirmation message box
appears.
3. Click the Yes button. The new waveform can be registered.

6. EMG
Saving Data on Disk
were acquired.
or press the F3 key on the keyboard on the Stop window.

F1 F2 F3 F4 F5 F6 F7 F8

6-3. CALCULATION
Deleting All Waveforms and Calculation Results
In the EMG examination program, you can delete all waveforms and calculation
results which are temporarily saved in memory.
1. On the Stop window, click the function button.
Append to Show Findings Cascade Findings Examination Patient

Superimpose
Saved Screen Saved Screen Summary Display Information Information
F1 F2 F3 F4 F5 F6 F7 F8 F9
2. Click the Erase All function button or press the F8 key on the keyboard.
Erase
All
F8 F9
3. The message window confirming the deletion appears. Click the Yes button.
All waveforms and calculation results are deleted.
To cancel deletion, click the Cancel button on the message window. The
message window closes.
6-3

Section 7 Nerve Conduction Study 7
7-1
7-2
7-3
Section 7-1 Nerve Conduction Study – Basic................................................................................................ 7.1.1
Section 7-2 Measurement – MCS.................................................................................................................. 7.2.1 7-4
Section 7-3 Calculation – MCS...................................................................................................................... 7.3.1
Section 7-4 Measurement – SCS................................................................................................................... 7.4.1 7-5
Section 7-5 Calculation – SCS....................................................................................................................... 7.5.1
Section 7-6 Measurement – Rep.Stim........................................................................................................... 7.6.1 7-6
Section 7-7 Calculation – Rep.Stim................................................................................................................ 7.7.1
Section 7-8 Measurement – F-wave............................................................................................................... 7.8.1 7-7
Section 7-9 Calculation – F-wave................................................................................................................... 7.9.1

7-8
Section 7-10 Measurement – H-reflex............................................................................................................ 7.10.1
Section 7-11 Calculation – H-reflex................................................................................................................ 7.11.1
7-9
Section 7-12 Measurement – Blink................................................................................................................ 7.12.1
Section 7-13 Calculation – Blink.................................................................................................................... 7.13.1
7-10
Section 7-14 NCS (Nerve Conduction Studies)............................................................................................. 7.14.1
7-11
7-12
7-13
7-14

Section 7-1 Nerve Conduction Study 7
– Basic
7-1
Operation Flow.................................................................................................................................................. 7.1.2

Settings for Each Examination Program.................................................................................................. 7.1.8
MCS and SCS............................................................................................................................... 7.1.8
Rep. Stim..................................................................................................................................... 7.1.11
F-wave......................................................................................................................................... 7.1.15
H-reflex........................................................................................................................................ 7.1.17
Blink............................................................................................................................................ 7.1.19
(Stop Window)....................................................................................................................................... 7.1.24

7. NERVE CONDUCTION STUDY
Operation Flow
Connect the electrode leads and stimulator to the appropriate

instrument.

window.

7-1. NERVE CONDUCTION STUDY – BASIC
7
7-1

Measurement window.

3. Enter the patient information such as ID No. Name, etc. For details, refer to

7
7-1
Or,

Or,

Category tab



box.

the window.

F1 F2 F3 F4 F5 F6 F7 F8


7
7-1
2. Select the condition tab that you want to check. The condition tabs are at the
top of the window.
Condition tab
manual.


MCS and SCS
Amp. Page
Item Description
to X8 and DIN
Acquisition Page
Item Description
and average.
Preset Count Selects the number of waveforms to acquire for averaging.
Trigger Page
Item Description
keyboard.
Electric Page
Item Description
key.

Display Page 7
Item Description
7-1
windows.
Labeling Page
Item Description
position is set in “Mark Position”.
Mark Position Selects the amplitude mark position on the response waveform when the Auto
Mark check box is checked.
Area Calculation Mode Selects the area calculation mode.
Measure Table Type Selects the Measurement Table window.
Area Calculation Mode

Selects the area calculation mode
Baseline: Calculate the area bounded by the waveform, the baseline and the vertical lines from the two
marks (L1 and L2) to the baseline.
Mark: Calculates the area bounded by the waveform and the line between the two marks (L1 and L2).
Baseline: Calculates the area bounded by the waveform, the baseline and the
Mark: Calculates the area bounded by the waveform and the line between
the two marks (L1 and L2).

Misc. Page
Item Description
Window*
Right
NCS Page
Item Description
Calculate CCV Set whether or not to display the CCV on the NCS Measurement Table window.
To display the CCV, check the Calculate CCV check box.
Ratio Enter a variation of the conduction velocity per 0.1°C. Use the keyboard to enter
the ratio from 0.0 to 10.0, in steps of 0.1, in the Ratio box.
Reference Temperature Enter the reference skin temperature for the compensation (30.0 to 40.0°C, in
0.1°C steps).
CCV = CV + Ratio × (Reference Temperature − Temperature)
Measure Table Type II Select the type of the Measurement Table window Type II.

Rep. Stim 7
Amp. Page
7-1
Item Description
to X8 and DIN
Acquisition Page
Item Description
Analysis (/div) Selects the analysis time for horizontal length (scale/division) for trigger sweep.
Preset Count Selects the number of waveforms to acquire.
Trigger Page
Item Description
keyboard.
Electric Page
Item Description
key.

Labeling Page
Item Description
Area Calculation Mode Selects the area calculation mode.
Measure Table Type Selects the Measurement Table window type.
Marking Position
The mark position for automatic marking can be selected at the Measure Mode in the Rep. Stim
Measurement (on the Rep. stim page of the Set Conditions window). The default setting is Half.
<Half>
Area: The area bounded by the baseline, EXCLUSION PERIOD (mark1), and the first baseline crossing of
the waveform after the peak of upward deflection (mark2).
Amp.: The amplitude between the maximum peaks.
EXCLUSION PERIOD amplitude
mark2
Stimulation mark1
Mark position
mark1: appears at the position set on Exclusion Period (on the Rep. stim page of the Set Conditions
window)
mark2: appears at the first baseline crossing of the waveform after the peak of upward deflection
<Full>
Area: The area bounded by the baseline, EXCLUSION PERIOD (mark1), and the 9 div (mark2).
Amp.: The amplitude between the maximum peaks.
amplitude
EXCLUSION PERIOD area
mark2
9 div
Stimulation mark1
Mark position
mark1: appears at the position set on Exclusion Period (on the Rep. stim page of the Set Conditions
window)
mark2: appears on the 9 div from the stimulation point.
• Exclusion Period: Set the Exclusion Period in the Rep. Stim Measurement box on the Rep. stim page of
the Set Conditions window.
This item selects a time interval after the trigger point. Amplitude and area are not
calculated for this interval because stimulus artifact may be included in this interval.
After this exclusion period interval elapses, the calculation starts.

Rep. stim Page 7
7-1
Item Description
Analysis Wave No. Select up to 10 wave Nos. to select the response waveform to be used for
decrement ratio calculation. The waveform for the selected Wave No. is used for
decrement ratio calculation.
Exclusion Period This item selects a time interval after the trigger point. Amplitude and area are
not calculated for this interval because stimulus artifact may be included in this
interval. After this exclusion period interval elapses, the calculation starts.
Measure Mode Selects either Half or Full.
Number of Bar Number of waveforms for one record on the summary graph.
Number of Sequence Number of sequences to perform.
Setting range is 1 to 12, OFF.
For example, when this item is 6, the system performs sequences 1 to 6. When
OFF is selected, the system performs no sequence.
Rec. Stim. Check the box to acquire waveforms of that sequence.
Stim Rate Stimulation frequency
Preset Count Number of waveforms to be acquired.
Tetanic/Contract Check this box to output the stimulation of the selected Stim. Rate. When the
examiner gives the patient muscle movement instruction, uncheck the box.
Train Time Duration period of stimulation.
Interval Interval between sequences. (in 1 second steps)

Misc. Page
Item Description
Right

F-wave 7
Amp. Page
7-1
Item Description
to X8 and DIN
Right Sens. When “Dual Sens” is checked, the sensitivity of the second period is a multiple
(×2, ×5, ×10, ×20, ×50, or ×100) of the first period.
Split Pos Selects the sensitivity separating position when “Dual Sens” is checked.
Smoothing Check this box to smooth the waveform in the second period by the moving
average method when “Dual Sens.” is checked.
Smoothing Point Selects the number of sampling points when “Smoothing” is checked.
Acquisition Page
Item Description
and average.
Trigger Page
Item Description
keyboard.

Electric Page
Item Description
key.
Display Page
Item Description
windows.
Labeling Page
Item Description
Misc. Page
Item Description
Window*
Right

H-reflex 7
Amp. Page
7-1
Item Description
to X8 and DIN
Acquisition Page
Item Description
and average.
Trigger Page
Item Description
keyboard.
Electric Page
Item Description
key.

Display Page
Item Description
windows.
Labeling Page
Item Description
Misc. Page
Item Description
Window*
Right

Blink 7
Amp. Page
7-1
Item Description
Electrode (+) from A1, A2, A+, Fz, Pz, C3, C4, Cz, Oz, LO, RO, LT, RT, C5S, EP1, EP2, X1,
X2, X3, X4, X5, X6, X7, X8 and DIN
Fast Recovery Check this box to immediately recover the baseline which is affected by
stimulation artifact. The time constant is set to 15.9 seconds for 1 ms after
stimulation.
Acquisition Page
Item Description
and average.
Trigger Page
Item Description
keyboard.
Electric Page
Item Description
key.

Labeling Page
Item Description
Misc. Page
Item Description
Window*
Right Default setting: single output from the R side.

7
7-1
Four operation modes are used for measurement in this system. Select a mode
with the MONITOR, STIM/SWEEP, ANALYSIS or STOP key on the operation
panel.

and the raw waveform is displayed. Check that the electrodes are properly
attached and there is no artifact.
Amplifier
sensitivity
Monitoring time


the Monitor window changes to the Sweep window. Evoked waveforms are
displayed on the Sweep window.
window.
Preset number of waveforms to acquire Number of acquired waveforms
Sensitivity

Starting Averaging (Average Window) 7

SCS
Press the ANALYSIS key on the operation panel. The Sweep window changes to 7-1
the Average window and averaging of the acquired waveforms starts. You can set
the number of waveforms to average.
Preset number of waveforms to average Number of averaged waveforms
Number of rejected
waveforms
Sensitivity
MCS, Rep. stim, F-wave, H-reflex and Blink

Press the ANALYSIS key on the operation panel. The Sweep window changes to
the Analysis window and acquiring of the sweep waveforms starts. You can set
the number of waveforms to acquire.
In the Rep. stim program, when items in the Test Sequence on the Rep. stim page
are set, the system performs selected sequences.
Preset number of
Number of averaged
waveforms
Sensitivity


(Stop Window)
window, Average or Analysis window changes to the Stop window and
monitoring, acquisition or averaging stops. The latest acquired or averaged
waveforms are displayed on the Stop window and you can measure the
waveforms or save them in the hard disk.
Preset number of waveforms to acquire or average Number of rejected waveforms

Section 7-2 Measurement – MCS 7
7-2
General.............................................................................................................................................................. 7.2.2
Features.................................................................................................................................................. 7.2.2
Preparation........................................................................................................................................................ 7.2.3
Measurement..................................................................................................................................................... 7.2.5
Entering the Nerve Name........................................................................................................................ 7.2.5
Printing Data........................................................................................................................................... 7.2.7

General
This program measures the velocity of an impulse through a motor nerve (MCV,
motor conduction velocity). MCV is calculated from the waveform latency and
the distance between two electrical stimulation points on the nerve using evoked
potential derived from electrodes.
Features
• Marks can be set either automatically or manually. The default setting is Auto.
• The nerve conduction velocity is automatically calculated when the distance
between the stimulation sites is entered after the latency cursors are set or the
response waveforms are marked.
• Latency, duration, amplitude, area, amplitude ratio, area ratio, NCV and
CCV (NCV compensated with skin temperature) can be displayed in the
• The settings in which the waveform was acquired can be displayed in the
Condition Table window.

7-2. MEASUREMENT – MCS
7
Preparation
Electrode Attachment and Connection 7-2
as shown on the following pages.

box cable to the SOMATO connector on the right side panel of the main unit.
4. Attach the recording electrodes with paste to the optimal sites as shown on
the following pages.
5. Attach the grounding electrode with Elefix between the active electrode and
the stimulating electrode.
NOTE
CH1 (−) Active electrode CH1 (+) Reference electrode
Grounding electrode

Electrode placement examples
<Median nerve>
Recording site: Abductor pollicis brevis
Active electrode (−): Abductor pollicis brevis
Reference electrode (+): Tendon of the abductor pollicis brevis
8 cm
Stimulation site (1)

(Distal) Stimulation site (2)
Between the tendons of the (Proximal)
flexor carpi radialis muscle Medial to the palpable
and musculus palmaris brachial artery at the elbow
longus at the wrist
<Ulnar nerve>
Recording site: Abductor digiti minimi
Active electrode (−): Midportion of the abductor digiti
minimi
Reference electrode (+): Tendon of the abductor digiti minimi
(Proximal phalanx of the fifth digit)
8 cm
(Distal)
Radial to the flexor carpi
ulnaris tendon at the wrist

(Proximal)
<Tibial nerve> Proximal to the sulcus nervi ulnaris
Stimulation site (2) Stimulation site (1) (behind the medial epicondyle of the
(Proximal) (Distal) humerus)
Middle of the popliteal fossa Slightly posterior to the medial malleolus
8 cm
<Peroneal nerve>
pillow (Distal)
Between the tendons of the tibialis
Recording site anterior and extensor hallucis
Active electrode (−): Abductor hallucis
Reference electrode (+): Hallux base (Near the big toe)
Stimulation site (2) 8 cm

(Proximal)
Lateral popliteal fossa pillow
(Medial to the biceps femoris tendon)
Recording site
Active electrode (−): Musculus extensor digitorum brevis
Reference electrode (+): Near the little toe

7
Measurement
Selecting the Program and Changing Measurement Settings 7-2

and change settings.
1. Select the NCS tab in the category tab on the Main Menu window. The
2. Select the MCS program on the Main Menu window. The MCS examination
program window opens. The wave area, MCS Measurement Table window,
NCS Measurement Table window, Temperature window, and Nerve Table
window are displayed in the MCS examination program window.
Entering the Nerve Name

Enter the nerve name to be examined and its side on the Nerve Table window.
1. Click the Nerve Input function button or press the F7 key on the keyboard to
open the Nerve Table.

F1 F2 F3 F4 F5 F6 F7 F8
2. From the keyboard, type in the nerve name in the text box. Or, click the
Nerve List... button and select a nerve name from the list.
3. Click either the Left or Right check box. You can also select the side by
pressing the SIDE/SET key on the operation panel.
4. Click the OK button.

4. Place the stimulating electrode on the stimulation site. The black marked
side of the NM-420S is minus (−). Fix the surface stimulation electrode to
the site with the strap (included in NM-420S).
5. While checking the waveform, turn the stimulation intensity dial on the
operation panel to gradually increase the stimulus intensity. The response
waveform elicited by each electric stimulation appears on the window.
6. Gradually increase the stimulus intensity to 20 to 25% more than the

intensity which obtained the maximal compound muscle action potential
(Supramaximal Stimulation).
7. Press the STOP key on the operation panel to stop the stimulation and
display the last response waveform obtained before the STOP key was
pressed.
8. Save the acquired waveform temporarily in memory.

memory when the STOP key is pressed.
9. Press the Reset key on the operation panel to set the stimulation intensity to
0 mA.
10. Move the stimulating electrode to the next examined site.
11. Repeat steps 2 to 9.
12. Calculate the nerve conduction velocity. Refer to “Nerve Conductive

Velocity Calculation”.


• Calculation of nerve conduction velocity
• Manual marking
7-2
• Automatic marking
• CCV (Compensated Conduction Velocity) setting
• Printing data
Deleting Waveforms
selected.
selected.
deletion appears.
Saving Data on Disk

Printing Data

Section 7-3 Calculation – MCS 7
7-3
General.............................................................................................................................................................. 7.3.2
Nerve Conduction Velocity Calculation.............................................................................................................. 7.3.3
Calculation with Cursors.......................................................................................................................... 7.3.3
Calculation with Marks............................................................................................................................ 7.3.5
Marking.............................................................................................................................................................. 7.3.6
Moving a Mark......................................................................................................................................... 7.3.8
Deleting Marks........................................................................................................................................ 7.3.9
Measurement Table Windows.......................................................................................................................... 7.3.10
To Open the Measurement Table Window............................................................................................. 7.3.10
To Close the Measurement Table Window............................................................................................ 7.3.11
MCS Measurement Table Window........................................................................................................ 7.3.12
NCS Measurement Table Window......................................................................................................... 7.3.13
Entering Segment Waveforms..................................................................................................... 7.3.13
Entering Skin Temperature.......................................................................................................... 7.3.14
MCS Measurement Table Window........................................................................................................ 7.3.15
Entering the Site......................................................................................................................... 7.3.16
Changing the Waveform Order.................................................................................................... 7.3.16

General
In the MCS examination program, the following calculation operations are

available.

• Manual marking

7-3. CALCULATION – MCS
7
Nerve Conduction Velocity Calculation
There are two ways to calculate the nerve conduction velocity.

• Calculation with cursors
• Calculation with marks 7-3
Calculation with Cursors

When the latency cursors are set and the distance between the two stimulation
sites is entered, the nerve conduction velocity is automatically calculated.
Latency 1, Latency 2, the interval and the NCS are displayed in the Latency
window.
NOTE
The nerve conduction velocity measured with cursors cannot be saved.
Only the nerve conduction velocity measured with marks can be saved
in memory.
1. Press the LAT/AMP/TRIG key on the operation panel, or click the

button on the Tool bar. The Latency cursor and Latency window appear on
the wave area.
cursor A
cursor B
When the STOP key is pressed during measurement, the LAT/AMP/TRIG

key on the operation panel or the button on the Tool bar becomes
automatically pressed.

2. Press the A/B key on the operation panel to select cursor A.
3. Set the vertical line cursor on the optimal onset point of the distal waveform
with the CURSOR dial on the operation panel. You can also drag and move
the vertical line cursor.
4. Press the A/B key to select cursor B.
5. Set the vertical line cursor on the optimal onset point of the proximal
waveform with the CURSOR dial on the operation panel. You can also drag
and move the vertical line cursor.
6. Measure the distance between the stimulation sites.
7. Enter the distance in the Distance (mm) box with the keyboard or by using
the and buttons next to the Distance (mm) box.
The nerve conduction velocity appears in the NCV row in the Latency
window.

Calculation with Marks 7

When the marks are set on the waveforms and the distance between the two
stimulation sites is entered, the nerve conduction velocity is automatically
calculated.
1. If automatic marking function is not on, set the marks “Lat. 1” manually on 7-3
the waveform.

2. Click the Measurement Table function button on the Stop window, or press
the F2 key on the keyboard. The MCS Measurement Table window appears.

F1 F2 F3 F4 F5 F6 F7 F8
Cursor movement in the Measurement Table window

To move the cursor, do one of the following.
• Press the TAB key.
• Press the SHIFT key and TAB key simultaneously.
• Click the column.

4. Enter the distance in the Dist (mm) column in the MCS Measurement Table
window with the keyboard.
The nerve conduction velocity appears in the NCV column in the MCS
Nerve conduction velocity
Distance between the

stimulation sites

Marking



F1 F2 F3 F4 F5 F6 F7 F8
Vertical cursor

2. Do one of the following to set a mark. 7

highlighted.
The selected mark appears on the clicked point. On the Mark Label window, 7-3
one waveform.

operation panel.
marked.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
cursor point.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
on the keyboard.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8


the Labeling Page
With the following procedure, marks are set according to the settings on the
Labeling page on the Set Conditions window after waveform acquisition.

operation panel.
on the keyboard.

F1 F2 F3 F4 F5 F6 F7 F8
3. Click the function button.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
on the keyboard.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
Moving a Mark
the “Setting One Mark at a Time” procedure. The selected mark moves to the
new position.

Deleting Marks 7
delete the mark by clicking the function button twice. 7-3
• Or,
1. On the Mark Label window, click the mark label to delete. The cursor
moves to the mark position.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
Deleting All Marks

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8

There are two types of Measurement Table windows, Type I and Type II. Select either Type I or Type II on the Labeling
page on the Set Conditions window.
Type I: Displays the MCS Measurement Table window and the NCS Measurement Table window.
Type II: The MCS Measurement Table window and the NCS Measurement Table window are combined in one table
window. Displays waveform. The Routine window or S-impose window can be selected on the NCS page on the
<Type I> <Type II>
MCS Measurement Table window - Routine
MCS Measurement Table window
MCS Measurement Table window - S-impose
NCS Measurement Table window

function button.

F1 F2 F3 F4 F5 F6 F7 F8

To Close the Measurement Table Window 7

7-3

following windows open.
When the waveforms are marked, the system automatically starts calculation and
displays the results in the Measurement Table window.
MCS Measurement Table Window

Lat.: Latency from the trigger point to Lat. 1 (Mark 1)
Dur.: Duration between Lat. 1 (Mark 1) and Lat. 2 (Mark 2)
Amp.: Potential difference between Amp. 1 (Mark 3) and Amp. 2 (Mark 4).
Area: Area between Lat. 1 (Mark 1) and Lat. 2 (Mark 2) which is
calculated according to the Area Mode on the Labeling page of the
Set Conditions window
Stim.1, 2: Final stimulus intensity per stimulus channels.
Stimulus intensities for each stimulus channel are displayed.
Stim 2 is displayed only for the data measured with other model
instruments.

Annotation column.
You can also annotate a waveform on the Wave Annotation window. Refer to

NCS Measurement Table Window 7
7-3
Segment: Paired waveforms for measurement.

Insert “-” between the two wave numbers. (for example,
A1-B1).
When the pair is marked with “*”, NCV calculation is not
performed.
Dist.: Distance between the waveforms in the Segment column
(unit in mm)
Interval: Time interval between respective Lat. 1 (Mark 1) on
paired waveforms (Segment waveform).
When only one waveform name is in the Segment text
box, the interval between trigger point and Mark 1.
NCV: Motor nerve conduction velocity without skin temperature
compensation
Temp.: Skin temperature (0.1°C steps)
CCV: Motor nerve conduction velocity compensated for skin
temperature.
Normative Data: Normative value for motor nerve conduction velocity
Amp. (%): Potential difference ratio of paired waveforms (Segment
waveforms).
Area (%): Area ratio of paired waveforms (Segment waveforms).
Entering Segment Waveforms
1. On the NCS Measurement Table window, click the Segment column. The
cursor moves to the clicked column.
2. Enter the waveform number in the Segment column. When entering two
waveform numbers (only for Interval), insert “-” between the two waveform
numbers. For example, A1-B1.
When “*” is inserted before the waveform number, the NCV column for the
line is blank.

NCS Measurement Table window. A check mark appears in the box, and the
Normative Data column appears on the NCS Measurement Table window.
3. Enter the normative data with the keyboard.
Entering Skin Temperature
For the CCV calculation, enter the examined skin temperature.

To have the CCV calculated, check the CCV Calculate on the NCS page of the
1. On the NCS Measurement Table window, click the Temp. column. The
cursor moves to the clicked box.
2. From the keyboard, type in the examined skin temperature in 0.1°C steps,
and press the Enter key.
The CCV value is displayed in the CCV column in the NCS Measurement
Table window.

7
7-3
MCS Measurement Table Window

Number of averaged waveforms Stimulation intensity
Preset number of Number of rejected waveforms
waveforms to average Sensitivity Stimulation settings
Comment (stimulation
site)
Waveform order on the wave

window
Refer to “Table” in this section.
Paired waveforms
(The number is waveform order
on the wave window.)
Distance between the

waveforms in the Segment
column (unit: mm)
For single waveform, time interval

between the stimulating point and
Lat.1 (Mark 1).
For paired waveforms, time
interval between the respective
Lat. 1 (Mark 1) on paired
waveforms (segment waveform)
Click the Accept button to enter the

The interval of the paired
temperature with the keyboard.
waveform is shown in a bar graph.
Waveforms on the wave window are
Calls up a normative data file
superimposed.
Lat.: Latency from the trigger point to Lat. 1 (Mark 1)

Amp.: Potential difference between Amp. 1 (Mark 3) and Amp. 2 (Mark 4)
Area: Area between Lat. 1 (Mark 1) and Lat. 2 (Mark 2) which is calculated
according to the Area Mode on the Labeling page of the Set Conditions
window

Stim.1: Final stimulation intensity per stimulation channels.

Stimulation intensities for each stimulation channel are displayed.
NCV: Motor nerve conduction velocity
CCV: Motor nerve conduction velocity compensated for skin temperature
NR(+/−2SD): Refer to “Displaying Normative Range”.
Entering the Site
Click the column you want to enter the site in. Then, enter the site from the
keyboard.
Changing the Waveform Order
When the waveform order is changed on the window, the order in the table also
changes automatically.
No. Site Calculation Value No. Site Calculation Value

1 WRIST A1 calculation result 1 WRIST C1 calculation result
2 ELBOW B1 calculation result 2 ELBOW B1 calculation result
3 C1 calculation result
When a CSV file is selected in the Normative data file box, following data is
displayed in the NR(+/−2SD) column.
Normative range (normative value ± 2SD)
Mark position is in normative range
Mark position is out of normative range
To display the calculation value and normative value as a pop-up, place the
mouse cursor on the bar, or .

Creating the CSV File 7

You can create a normative data file. Using the Excel spreadsheet is

7-3

First line: Title
Second
line:
Comment
Third line: Second bar in the NR(+/− 2SD) column Maximum value of the
Data and sd for setting Interval column
the normative range
First bar in the NR(+/− 2SD) column

First line: Title
Second
line:
Comment
Third line:
the normative range

Use any file name.

Saving Data on Disk
were acquired.
on the Stop window.

Marking Superimpose
F1 F2 F3 F4 F5 F6 F7 F8

7
Labeling page of the Set Conditions window. Refer to the MEB-9400 operator’s 7-3
manual for details.
the Stop window.

Marking Superimpose
F1 F2 F3 F4 F5 F6 F7 F8

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8

Table window.

Section 7-4 Measurement – SCS 7
General.............................................................................................................................................................. 7.4.2
Features.................................................................................................................................................. 7.4.2 7-4
Preparation........................................................................................................................................................ 7.4.3
SCS Orthodromic.......................................................................................................................... 7.4.3
SCS Antidromic............................................................................................................................. 7.4.3
Measurement..................................................................................................................................................... 7.4.7
Printing Data......................................................................................................................................... 7.4.10

General
This program measures the sensory nerve conduction velocity. Sensory nerve
conduction velocity is the speed of an impulse through a sensory nerve. SCV is
calculated from the waveform latency and the distance between the electrical
stimulation point and the recording point.
Features
• The marks can be set automatically.
• The nerve conduction velocity is automatically calculated when the distance
between the stimulation sites is entered after the latency cursors are set or
when the response waveforms are marked.
• Latency, amplitude, CV (NCV) and CCV (NCV compensated for skin
temperature) can be displayed in the Measurement Table window.

7-4. MEASUREMENT – SCS
7
Preparation

SCS Orthodromic
1. Connect the recording electrode leads to the electrode jacks as shown on the
following page. 7-4

where the recording electrode will be attached. Rub the skin with an optimal
6. Attach the recording electrodes (disk electrode) with paste to the optimal
sites as shown on the following pages.
the stimulating electrode as shown on the following pages.
NOTE
SCS Antidromic
1. Use a finger electrode or a disk electrode for recording electrodes.

Connect the finger electrode lead to the electrode lead jack on the main unit
or electrode junction box. Connect the disk electrode leads to the electrode
jacks as shown on the following page.



amount of the Skinpure skin preparation gel to reduce artifact. Wipe the skin
6. Attach the recording electrodes with paste to the site as shown on the
following pages.
NOTE

Grounding electrode

Electrode placement examples 7
<Median nerve (Orthodromic)>
Stimulation:
Stimulating the forefinger with a finger electrode
Stimulation site
Cathode ring: Near the second proximal interphalangeal joint
Anode ring: Second distal interphalangeal joint
14 cm 7-4
A piece of gauze or cotton
should be held between the
forefinger and middle finger.
Recording site (1)

(Distal)
Between the tendons of the flexor Recording site (2)
carpi radialis muscle and musculus (Proximal)
palmaris longus at the wrist Medial to palpable brachial artery at the elbow
<Median nerve (Antidromic)>
Recording site:
Recording at the forefinger with a
finger electrode
Recording site
Active electrode (−): Near the second proximal interphalangeal joint
Reference electrode (+): Second distal interphalangeal joint
A piece of gauze or 14 cm
cotton should be held
between the forefinger
and middle finger.

(Distal)
Between the tendons of the flexor Stimulation site (2)
carpi radialis muscle and musculus (Proximal)
palmaris longus at the wrist Medial to palpable brachial artery at the elbow

<Ulnar nerve (Orthodromic)>
Stimulation:
Stimulating the little finger with a finger electrode
A piece of gauze or cotton should be held

between the ring finger and little finger.
Stimulation site
Cathode ring: Near the fifth proximal
interphalangeal joint
Anode ring: Fifth distal
interphalangeal joint 14 cm 90°
Recording site (1)

(Distal)
ulnaris tendon at the wrist Recording site (2)
(Proximal)
Proximal to the sulcus nervi ulnaris
(behind the medial epicondyle of the
humerus)
<Ulnar nerve (Antidromic)>
Recording site:
Recording at the little finger with a finger electrode
A piece of gauze or cotton should be held

between the ring finger and little finger.
Recording site
Active electrode (−): Near the fifth proximal
Reference electrode (+): Fifth distal
90°
14 cm

(Distal)
ulnaris tendon at the wrist Stimulation site (2)
(Proximal)
Proximal to the sulcus nervi ulnaris
(behind the medial epicondyle of the
humerus)
<Sural nerve (Antidromic)>
Stimulation site
Recording site Cathode electrode: Midcalf (the junction of gastrocnemius
Active electrode (−): Behind the lateral muscle and Achilles)
14 cm
malleolus
Reference electrode (+): Distal to the active
electrode
Pillow

7
Measurement

and the settings.
7-4
2. Select the SCS program on the Main Menu window. The SCS examination
program window opens. The wave area, SCS Measurement Table window,
NCS Measurement Table window, Temperature window, and Nerve Table
window are displayed in the SCS examination program window.


F1 F2 F3 F4 F5 F6 F7 F8


output and to display the waveforms.
4. Place a surface stimulation electrode or SOMATO control box on the

stimulation site. The black marked side of the NM-420S surface stimulation
electrode is minus (−).
operation panel to gradually increase the stimulation intensity.
<Orthodromic>
First, increase the stimulation intensity from 0 mA until the patient feels
the stimulation. (This intensity is the Sensing Threshold.) Then, gradually
increase the intensity to three times as high as the sensing threshold.
<Antidromic>
Increase the stimulation intensity from 0 mA until the amplitude of the
response waveform becomes maximum. Too strong stimulation causes
artifact.
CAUTION
Take care not to increase the intensity excessively. Excessive
stimulation to the periphery causes pain to the patient.
6. If averaging is necessary, press the ANALYSIS key on the operation panel.

Artifact is removed from averaging.
stimulation stop automatically. When the averaging is completed, the
window changes to the Stop window.

7. Save the waveforms temporarily in memory. 7

8. Press the Reset key to set the stimulation intensity to 0 mA.

7-4
9. When performing Orthodromic measurement, move the recording electrode

to the next recording site. When performing Antidromic measurement, move
the stimulating electrode to the next stimulating site.
10. Repeat steps 2 to 8.
11. Calculate the sensory nerve conduction velocity. Refer to “Nerve Conductive
Velocity Measurement”.

• Nerve Conduction Velocity Measurement
• Marking
• Saving data on a disk.
• Printing data
Deleting Waveforms
selected.
selected.

deletion appears.
Saving Data on Disk

Printing Data

Section 7-5 Calculation – SCS 7
General.............................................................................................................................................................. 7.5.2
Nerve Conduction Velocity Calculation.............................................................................................................. 7.5.3
Calculation with Marks............................................................................................................................ 7.5.5 7-5
Marking.............................................................................................................................................................. 7.5.6
Automatically Setting Multiple Marks According to the Settings on the Labeling Page................. 7.5.8
Moving a Mark......................................................................................................................................... 7.5.8
Deleting Marks........................................................................................................................................ 7.5.9
SCS Measurement Table Window......................................................................................................... 7.5.12
NCS Measurement Table Window......................................................................................................... 7.5.13
Entering Segment Waveforms..................................................................................................... 7.5.13
Entering Skin Temperature.......................................................................................................... 7.5.14
SCS Measurement Table Window......................................................................................................... 7.5.15
Entering the Site......................................................................................................................... 7.5.16
Changing the Waveform Order.................................................................................................... 7.5.16

General
In the SCS examination program, the following calculation operations are

available.

• Manual marking
• Displaying the Condition Table Window
• Annotating a Waveform

7-5. CALCULATION – SCS
7
Nerve Conduction Velocity Calculation
There are two ways to calculate the nerve conduction velocity.

• Calculation with marks

7-5
When the latency cursors are set and the distance between the two stimulation
sites is entered, the nerve conduction velocity is automatically calculated.
Latency 1, Latency 2, the interval and the NCS are displayed in the Latency
window.
NOTE
The nerve conduction velocity measured with cursors cannot be saved.
Only the nerve conduction velocity measured with marks can be saved
in memory.
1. Press the LAT/AMP/TRIG key on the operation panel, or click the

button on the Tool bar. The Latency cursor and Latency window appear on
the wave area.
Latency window
Latency cursor B
Latency cursor A


2. Press the A/B key on the operation panel to select latency cursor A.
3. Set the cursor on the optimal onset point of the distal waveform with the
CURSOR dial on the operation panel. You can also drag and move the
cursor.
4. Press the A/B key to select latency cursor B.
5. Set the cursor on the optimal onset point of the proximal waveform with
the CURSOR dial on the operation panel. You can also drag and move the
cursor.
7. Enter the distance in the Distance (mm) box with the keyboard or by using
the and buttons next to the Distance (mm) box.
The nerve conduction velocity appears in the NCV row in the Latency
window.


When the marks are set on the waveforms and the distance between the two
stimulation sites is entered, the nerve conduction velocity is automatically
calculated.
1. If automatic marking function is not on, set the marks “Lat. 1” manually on
the waveform.
the F2 key on the keyboard. The SCS Measurement Table window (type II) 7-5
appears.

F1 F2 F3 F4 F5 F6 F7 F8

4. Enter the distance in the Dist (mm) column in the SCS Measurement Table
window with the keyboard.
The nerve conduction velocity appears in the NCV column.
For details, refer to “Measurement Table Window Type II Description” in

this section.

Marking
Marks can be set automatically or manually.




F1 F2 F3 F4 F5 F6 F7 F8
Vertical cursor


highlighted.
one waveform.
7-5
operation panel.
marked.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
cursor point.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
on the keyboard.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8

Automatically Setting Multiple Marks According to the Settings on

the Labeling Page

operation panel.
on the keyboard.

F1 F2 F3 F4 F5 F6 F7 F8

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
on the keyboard.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
Moving a Mark
On the Mark Label window, select the mark label you want to move. Then, do
new position.

Deleting Marks 7
7-5
• Or,

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
Deleting All Marks

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8

There are two types of Measurement Table windows, Type I and Type II. Select either Type I or Type II on the Labeling
Type I: Displays the SCS Measurement Table window and the NCS Measurement Table window.
Type II: The SCS Measurement Table window and the NCS Measurement Table window are combined in one table
window. Waveforms are displayed. The Routine winodow or S-impose window can be selected on the NCS page
on the Set Conditions window.
<Type I> <Type II>
SCS Measurement Table window - Routine
SCS Measurement Table window
SCS Measurement Table window - S-impose
NCS Measurement Table window

function button.

F1 F2 F3 F4 F5 F6 F7 F8


7-5

SCS Measurement Table Window

Lat.1: Latency from the trigger point to Lat. 1 (Mark 1)
Lat.2: Latency from trigger point to Lat. 2 (Mark 2)
Amp.: Potential difference between Amp. 1 (Mark 3) and Amp. 2 (Mark 4)
Area: Area between Lat. 1 (Mark 1) and Lat. 2 (Mark 2) which is
calculated according to the Area Mode on the Labeling page of the
Set Conditions window
Stim.1, 2: Final stimulus intensity per stimulus channels.
Stimulus intensities for each stimulus channel are displayed.
Stim.2 is displayed only for the data measured with other model
instruments.

Annotation column.

NCS Measurement Table Window 7
7-5
Segment: Paired waveforms for measurement.

Insert “-” between the two wave numbers. (for example,
A1-B1).
When the pair is marked with “*”, NCV calculation is not
performed.
Dist.: Distance between the waveforms in the Segment column
(unit in mm)
Interval: Time interval between respective Lat. 1 (Mark 1) on paired
waveforms (Segment waveform).
NCV: Nerve conduction velocity without skin temperature
compensation
Temp.: Skin temperature (0.1°C steps)
CCV: Nerve conduction velocity compensated for skin
temperature.
Normative Data: Normative value for nerve conduction velocity
Amp. (%): Potential difference ratio of paired waveforms (Segment
waveforms).
Area (%): Area ratio of paired waveforms (Segment waveforms).
Entering Segment Waveforms
1. On the NCS Measurement Table window, click the Segment column. The
2. Enter the waveform number in the Segment column. When entering two
waveform numbers (only for Interval), insert “-” between the two waveform
numbers. For example, A1-B1.
When “*” is inserted before the waveform number, the NCS column for the
line is blank.

NCS Measurement Table window. A check mark appears in the box, and the
Normative Data column appears on the NCS Measurement Table window.
3. Enter the normative data with the keyboard.
Entering Skin Temperature
For the CCV calculation, enter the examined skin temperature.

To have the CCV calculated, check the CCV Calculate on the NCS page of the
1. On the NCS Measurement Table window, click the Temp. column. The
2. From the keyboard, type in the examined skin temperature in 0.1°C steps,
and press the Enter key.
The CCV value is displayed in the CCV column in the NCS Measurement
Table window.

7
When the waveforms are marked, waveform measurement starts automatically

and the results can be displayed in the Measurement Table window.
7-5
SCS Measurement Table Window

Number of averaged waveforms Stimulation intensity
Preset number of Stimulation settings
waveforms to average Sensitivity
Comment (stimulation
site)
Waveform order on the

wave window
Refer to “Changing the Waveform
Order” in this section.
Paired waveforms
(The number is
waveform order on the
wave window.)
Distance between
the waveforms in the
Segment column
(unit: mm)
For single waveform, time interval

between the stimulating point and
Lat.1 (Mark 1).
For paired waveforms, time
interval between the respective
Lat. 1 (Mark 1) on paired
waveforms (segment waveform)
Calls up a normative data file
Waveforms on the wave window The interval of the paired waveform is

are superimposed. shown in a bar graph.

Area: Area between Lat. 1 (Mark 1) and Lat. 2 (Mark 2) which is calculated
according to the Area Mode on the Labeling page of the Set Conditions
window

Stim.1: Final stimulation intensity per stimulation channels.

NCV: Nerve conduction velocity
CCV: Nerve conduction velocity compensated for skin temperature
Entering the Site
Click the column you want to enter the site name and enter the site from the
keyboard.
Changing the Waveform Order
When waveforms are moved, added or deleted in the window, the table is
automatically updated to reflect this.
No. Site Calculation Value No. Site Calculation Value

1 WRIST A1 calculation result 1 WRIST C1 calculation result
2 ELBOW B1 calculation result 2 ELBOW B1 calculation result
3 C1 calculation result
When a CSV file is selected in the Normative data file box, the following data is
displayed in the NR(+/−2SD) column.
Normative range (normative value ± 2SD)

Mark position in normative range
Mark position out of normative range
To display the calculation value and normative value, set the mouse at the bar,
or .

Creating the CSV File 7

You can create a normative data file. Using an Excel spreadsheet is
7-5
- The data and SD have 3 significant digits and 2 decimal places. Both the
data and SD must be entered together.

First line: Title
Second line:
Comment
Third line:
Data and SD for setting Second bar in the NR(+/− 2SD) column
the normative range
First bar in the NR(+/− 2SD) column

First line: Title
Second line:
Comment
Third line:
the normative range

Use any file name.

Saving Data on Disk
were acquired.
on the Stop window.

Marking Superimpose
F1 F2 F3 F4 F5 F6 F7 F8

7
manual for details.
the Stop window. 7-5

Marking Superimpose
F1 F2 F3 F4 F5 F6 F7 F8

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8

Table window.

Section 7-6 Measurement – Rep.Stim 7
General.............................................................................................................................................................. 7.6.2
Features.................................................................................................................................................. 7.6.2
Preparation........................................................................................................................................................ 7.6.3
Measurement..................................................................................................................................................... 7.6.5
Selecting the Program and Changing Measurement Settings................................................................ 7.6.5 7-6
Automatic Measurement Procedure........................................................................................................ 7.6.7
Calling Up Waveforms and Data from Memory....................................................................................... 7.6.7
Printing Data........................................................................................................................................... 7.6.8

General
This program measures the amplitude/area decrement in muscle action potential

due to repetitive stimulation.
Features
• All the response waveforms appear on the window with the time scale
compressed to monitor each response waveform. (Compressed waveform
display)
• 10 response waveforms selected from all the response waveforms appear on
the window superimposed. The onset time of each waveform is shifted. (This
is called the Delayed-superimposed waveform display.)
• Up to 12 steps can be set for one automatic measurement.
• 10 waveforms can be marked, and each amplitude and area decrement ratio are
automatically calculated and displayed on the right side of the window. The
waveforms can be marked either automatically or manually.
• The response waveforms of up to 99 Rec. No.s can be saved temporarily in
memory.
• Measurement sites, amplitude, area and the decrement ratio of the waveform
are displayed in the Measurement Table window. The Rep. stim Measurement
Table window type II has the summary graph.

7-6. MEASUREMENT – REP.STIM
7
Preparation

following page.

on the right side panel of the main unit with the somato A → B connection 7-6

4. When using the surface stimulation electrode, soak the felt pads of the
surface stimulation electrode with water.
amount of the Skinpure skin preparation gel to reduce artifact. Wipe the skin
6. Attach the recording electrodes (disk electrode) with paste to the optimal
sites as shown on the following pages.
NOTE
• Make sure that the electrodes are properly attached and fixed.
• Do not short-circuit between the felt pads of the surface stimulation
electrode with water.
• To prevent artifact caused by muscle expansion/contraction, immobilize
the examined extremity.

Example: Rep.stim, Ulnar Nerve
Grounding electrode
Stimulation site
Radial to the flexor carpi ulnaris tendon at the wrist
CH1(−) Active electrode (−): Midportion of the abductor digiti minimi

CH1(+) Reference electrode (+): Tendon of the abductor digiti minimi
(Proximal phalanx of the fifth digit)
Recording site:
Abductor digiti minimi
(Both stimulating and recording electrodes are fixed.)
Grounding electrode

7
Measurement

2. Select the Rep. stim program on the Main Menu window. The Rep. stim 7-6
examination program window opens. The wave area and Nerve Table
window are displayed in the Rep. stim examination program window.


F1 F2 F3 F4 F5 F6 F7 F8


output (stimulation rate is fixed to 1 Hz) and to display the waveforms.
4. Place the surface stimulation electrode or the SOMATO control box probes
on the stimulation site.
The black marked side of the NM-420S surface stimulation electrode is
minus (−).
operation panel to gradually increase the stimulation intensity. The response
6. Gradually increase the stimulation intensity to 20 to 25% more than the

(This is the supramaximal stimulation).
7. Press the STOP key on the operation panel.

• Fix the surface stimulation electrode to the stimulation site with the
retaining strap or adhesive tape.
• Do not change the stimulation intensity of step 6.
• Let the examined muscle rest for at least 30 seconds before performing
repetitive stimulations.
8. Press the ANALYSIS key on the operation panel to start the repetitive
stimulation at the preset stimulation rate. (The rate is set in the Trigger page
of the Set Conditions window.)
When the number of stimulations reaches the preset value (set at Preset
Count on the Acquisition page of the Set Conditions window), the
stimulation stops automatically.

The Rec No. (Recording No.) appears on the upper right corner of the
window. When the next measurement starts, the Rec No. automatically
increases.
The response waveforms of up to 99 measurements can be saved temporarily
in memory.

Automatic Measurement Procedure 7

When the test sequence is set on the Rep. stim page on the Set Conditions
window, the system performs automatic measurement according to the
Test Sequence setting. For the settings, refer to “Checking and Changing
Measurement Settings” in this section.
To start the automatic measurement, press the ANALYSIS key on the operation
panel. While stimulation is given or during intervals, the remaining period is
displayed on the Rep.stim Measurement Table window (type II).
When the step which is set at Number of Sequence finishes, the automatic
measurement stops. You can also stop the automatic measurement by pressing 7-6
the STOP key.

• All displayed waveforms for up to 99 measurements can be saved with the
calculation results. These data can be displayed again and recalculated with a
different reference waveform.
• Displaying the Measurement Table Window
• Displaying the Summary window
• Calling up temporarily saved waveforms from memory
• Marking
• Saving data on a disk
• Printing data
Calling Up Waveforms and Data from Memory

Up to 99 measurement waveforms can be saved in memory. These data can be
displayed on the wave area of the Stop window.
Click the Rec. No. button or Rec. No. button to select the measurement
results to be displayed. Or, type in the recording number in the Rec. No. box.
The selected measurement result is displayed.

Deleting Waveforms
Waveforms and data for an unnecessary Rec. No. can be deleted.
1. On the Stop window, select the Rec. No. you want to delete by clicking
the or button at the right of the Rec. No. box. The temporarily saved
waveforms for the selected Rec. No. are displayed.
appears.
3. Check that the Rec. No. selection is correct, and press the ERASE key. The
selected Rec. No. is deleted.
Saving Data on Disk

Printing Data

Section 7-7 Calculation – Rep.Stim 7
General.............................................................................................................................................................. 7.7.2
Marking.............................................................................................................................................................. 7.7.3
Moving a Mark......................................................................................................................................... 7.7.5
Deleting Marks........................................................................................................................................ 7.7.6 7-7

Measurement Table Windows............................................................................................................................ 7.7.7
Rep.stim Measurement Table Window.................................................................................................... 7.7.8
Annotating a Waveform................................................................................................................. 7.7.9
Entering the Stim. Site and Recording Site................................................................................... 7.7.9
(Selecting the Reference Stim. No.).............................................................................................. 7.7.9
Selecting the Channel................................................................................................................... 7.7.9
Rep.stim Measurement Table Window.................................................................................................. 7.7.10
Selecting the Rec. No.................................................................................................................. 7.7.11
Entering the Stim. No.................................................................................................................. 7.7.11
Summary Graph.......................................................................................................................... 7.7.11
Displaying the Rep. stim Summary Window.................................................................................................... 7.7.12
To Open and Close the Rep.stim Summary Window............................................................................ 7.7.12
Description of the Rep. stim Summary Window.................................................................................... 7.7.12

General
In the Rep. stim examination program, the following calculation operations are
available.
• Marking
• Displaying the Measurement Table Window
• Displaying the Summary window
• Displaying the Condition Table Window
• Annotating a Waveform

7-7. CALCULATION – REP.STIM
7
Marking


• Setting one mark at a time 7-7


F1 F2 F3 F4 F5 F6 F7 F8
Vertical cursor


highlighted.
M_lat., M_amp. 1, M_amp. 2: 2) On the wave area, click a waveform at the point you want to add the mark.
One mark per record. The selected mark appears on the clicked point. On the Mark Label window,
F_lat., F_amp. 1, F_amp. 2:
One mark per sweep waveform
one waveform.

operation panel.
marked.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
cursor point.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
on the keyboard.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8


the Labeling Page

operation panel.
on the keyboard.

F1 F2 F3 F4 F5 F6 F7 F8
7-7

Marking Marking
F1 F2 F3 F4 F5 F6 F7 F8
on the keyboard.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
Moving a Mark
new position.

Deleting Marks
• Or,

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
Deleting All Marks

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8

7
Type I: For 10 response waveforms, the amplitude, area and decrement ratio
are displayed.
Type II: For 10 response waveforms, the amplitude, area and decrement ratio
are displayed. A summary graph is also displayed.
<Type I> <Type II>
7-7
Rep.stim Measurement Table window
Rep.stim Measurement Table window

function button.

F1 F2 F3 F4 F5 F6 F7 F8


For 10 response waveforms, the amplitude, area and decrement ratio are
displayed.
Rep.stim Measurement Table Window
Decr. (%)
Amplitude decrement ratio (1 − AMPSTIM / AMPREF) × 100%
Decr. (%)
Area decrement ratio (1 − AREASTIM / AREAREF) × 100%
Stim. Site: Stimulating site (up to 20 alphanumeric characters)

Recording Site: Recording site (up to 20 alphanumeric characters)
Stim Rate: Stimulus frequency for the channel displayed in the
Channel No.: box.
Reference Stim. No.: Stimulation number of reference waveform for decrement
ratio.
Channel No.: Channel used for measurement
Stim No.: Stimulation number for the waveform displayed on the
window
Annotation: Annotation displayed on the wave area
Amp.: Amplitude of waveform related to Stim No.
Area: Waveform area

Annotating a Waveform 7

Annotation column.
7-7
Entering the Stim. Site and Recording Site
1. Select the Stim. Site column or Recording Site column. The cursor moves to
the selected column.
2. Type in the stimulating site and recording site in each column.

(Selecting the Reference Stim. No.)
A response waveform can be selected as the reference waveform for the

decrement ratio calculation.
Each decrement ratio is calculated from the reference waveform.
1. Click the button on the right of the Reference Stim. No. box. The drop
down list opens.
2. Select the desired Wave. No. in the list. Only the Wave No. which are not set
to OFF at “Analysis Wave No.” on the Rep. stim page of the Set Conditions
window appears.
Selecting the Channel
Click the button on the Channel No. box. The drop down list appears. Select
the desired channel.

Rep.stim Measurement Table Window

For 10 response waveforms, the amplitude, area and decrement ratio are
displayed. A summary graph is also displayed.
Number of acquired waveforms Decr. (%):

Area decrement ratio
Sensitivity (1 − AREASTIM / AREAREF) × 100%
Recording number
Preset number of
waveforms to be acquired
Decr. (%):
Amplitude decrement ratio
(1 − AMPSTIM / AMPREF) × 100%
Summary graph:
Amplitude of the waveforms in Stim.
No. are displayed. One stick stands
for a response waveform.
Stim. Site: Stimulating site (up to 20 alphanumeric characters)

STIM settings: Stimulus settings for the channel displayed in the Channel
No.: box.
Reference Stim. No.: Stimulation number of reference waveform for decrement
ratio.
Channel No.: Channel used for measurement
Stim No.: Stimulation number for the waveform displayed on the
window
Amp.: Amplitude of waveform related to Stim No.
Area: Waveform area
Default button: Returns the contents in the Stim. No. column to the
settings at the Rep.stim page on the Set Conditions
window.
Selecting the Rec. No. 7

Click the and buttons on the Rec. No. box to select the desired recording
number.
Entering the Stim. No.
Select the Stim. No. column and type in the stimulation number from the
keyboard. Pressing the Default button returns the contents in the Stim. No.
column to the settings at Analysis wave No. on the Rep.Stim page of the Set
Conditions window.
7-7
Summary Graph
The amplitudes of response waveforms are shown. Graphs for up to 12 Rec. Nos.
can be displayed.
One bar stands for one response waveform. The number of the bars displayed in
the graph is set on Number of Bar on the Rep. stim page on the Set Conditions
window. When the number of response waveforms exceeds the number set at
Number of Bar, waveforms with the smaller Stim Nos. are displayed.
Bars for the waveforms of the selected Rec. No. are shown in green, and bars for
the waveforms of the other Rec. Nos. are shown in light blue.
You can jump to an other Rec. No. by clicking the corresponding graph. The
wave window and the Rep. stim Measurement Table displays data for the Rec.
No.
Below the graph, the stimulation rate and the amplitude decrement ratio of the
rightmost bar are displayed.
Stimulation rate
Amplitude decrement ratio of the rightmost bar

Displaying the Rep. stim Summary Window
The results of all Rep. Stim measurements are displayed on the Rep.stim
Summary window. Data of amplitude and area decrement ratio for up to 10
response waveforms are displayed for one Rec. No. measurement.
The Rep.stim Summary Window is correlated with the Rep. stim Measurement
Table window.
To Open and Close the Rep.stim Summary Window

To display the Rep.stim Summary window on the Stop window, click the
Summary function button or press the F4 key on the keyboard.
Measurement Condition Summary Examination Nerve Patient

Marking Superimpose
F1 F2 F3 F4 F5 F6 F7 F8
On the Rep.stim Summary window, the summary of amplitude decrement ratio

and area decrement ratio is displayed.
To close the Rep.stim Summary window, click the button on the window or
click the Summary function button or press the F4 key on the keyboard again.
Description of the Rep. stim Summary Window

Channel used for measurement
(Click the button on the Channel No. box. The drop
down list appears. Select the desired channel.)
Amplitude ratio related to the Clock time
reference waveform
Amplitude of the
reference waveform
Recording number
Area of the reference

waveform
Area Decrement(%) Stimulation rate

Area ratio related to the reference waveform

7
Saving Data on Disk

7-7
were acquired.
on the Stop window.

Marking Superimpose
F1 F2 F3 F4 F5 F6 F7 F8

manual for details.
the Stop window.

Marking Superimpose
F1 F2 F3 F4 F5 F6 F7 F8

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
5. Enter an annotation in the Annotation box or click the button of the

Table window.

Section 7-8 Measurement – F-wave 7
General.............................................................................................................................................................. 7.8.2
Features.................................................................................................................................................. 7.8.2
Preparation........................................................................................................................................................ 7.8.3
Measurement..................................................................................................................................................... 7.8.5
7-8
Calling Up Waveforms and Data from Memory....................................................................................... 7.8.7
Printing Data........................................................................................................................................... 7.8.8

General
Features
• Latency and amplitude of each F-wave are automatically measured and
displayed on the window in real time during measurement.
• With the Dual Sensitivity function, the M-wave is displayed on the left of the
window and the F-wave on the right.
• The F-wave conduction velocity is automatically calculated when the response
waveforms are marked and the distance between the stimulation site and the
spinal cord is entered. The marks can be set either automatically or manually.
• The following data are displayed in the Measurement table window.
- M-wave latency and amplitude
- F-wave latency and amplitude
- The latency between M-wave and F-wave
- F-wave conduction velocity
- F-wave occurrence ratio (Number of F-waves/Number of total waveform
traces)
• The following data are displayed in the F-wave histogram window.
- F-wave latency histogram
- Minimum, maximum, and mean value for each measurement
- Standard deviation
• Up to 10 measurement results can be temporarily saved in memory.
• Up to 9999 waveforms for one measurement can be temporarily saved in
memory.

7-8. MEASUREMENT – F-WAVE
7
Preparation

following page.


4. Soak the felt pads of the surface stimulation electrode with water. 7-8
amount of the skin preparation gel, Skinpure, to reduce artifact. Wipe the
skin thoroughly with dry gauze to remove any moisture and gel from the
skin.
6. Attach the active and reference electrodes with paste to the optimal sites.
Use the disk electrode for the active and reference electrodes.
NOTE

Example: F-wave, ulnar nerve
Grounding electrode
Stimulation site (Proximal): Ancon
Stimulation site (Distal)

Manus arthrosis or ancon
Put the (−) side towards the spinal cord.
CH1(−) Active electrode (−): Midportion of the abductor digiti minimi muscle
Recording
CH1(+) Reference electrode (+): Tendon of the abductor digiti minimi muscle
electrode
(Proximal phalanx of the little finger)

Grounding electrode

7
Measurement

2. Select the F-wave program on the Main Menu window. The F-wave
window are displayed in the F-wave examination program window.
3. Click the button on the Tool bar to display the Set Conditions window 7-8

open the Nerve Table window.

F1 F2 F3 F4 F5 F6 F7 F8


output and to display the waveforms.
4. Place the stimulating electrode on the stimulation site. Put the (−) side
proximal to the (+) side. The black marked side of the NM-420S surface
stimulation electrode is minus (−).
operation panel to gradually increase the stimulation intensity. The response
6. Gradually increase the stimulation intensity to 20 to 25% more than the

(This is the supramaximal stimulation). The M-wave and F-wave are
displayed with different sensitivities (Dual Sensitivity function).
7. Press the ANALYSIS key on the operation panel to start acquiring

waveforms used for F-wave measurement.
When the number of acquired waveforms reaches the preset value (set at
Preset Count on the Acquisition page of the Set Conditions window), the
stimulation stops automatically.
To display the sweep waveforms separately, click the Cascade Display

function button. The top waveform is the latest waveform.

The Rec No. (Recording No.) appears on the upper right corner of the
window. When the next measurement starts, the Rec. No. automatically
increases.
The response waveforms of up to 10 measurements can be saved temporarily

in memory.


• F-wave conduction velocity measurement
• Marking
• Calling up waveforms and data from memory
• Changing the F-wave sensitivity
• Displaying waveforms in cascade or superimposed format.
• Saving data on a disk
Calling Up Waveforms and Data from Memory

Up to 10 measurement waveforms can be saved in memory. These data can be
displayed on the wave area of the Stop window.
7-8
Click the Rec. No. button or Rec. No. button to select the measurement
results to be displayed. Or, type in the recording number in the Rec. No. box.
The selected measurement result is displayed on the wave area.
Deleting Waveforms
Waveforms and data for an unnecessary Rec. No. can be deleted.
1. On the Stop window, select the Rec. No. you want to delete by clicking
the or button at the right of the Rec. No. box. The temporarily saved
waveforms for the selected Rec. No. are displayed.
appears.
3. Check that the Rec. No. selection is correct, and press the ERASE key. The
waveforms and data for the selected Rec. No. is deleted.

Saving Data on Disk

Printing Data

Section 7-9 Calculation – F-wave 7
General.............................................................................................................................................................. 7.9.2
F-wave Conduction Velocity Measurement........................................................................................................ 7.9.3
Calculation with Marks............................................................................................................................ 7.9.5
Marking.............................................................................................................................................................. 7.9.6
Moving a Mark......................................................................................................................................... 7.9.8
Deleting Marks........................................................................................................................................ 7.9.9
7-9
F-wave Measurement Table Window............................................................................................................... 7.9.10
F-wave Measurement Table Window..................................................................................................... 7.9.11
Entering the Stim. Site and Recording Site................................................................................. 7.9.12
Entering the Distance (mm)........................................................................................................ 7.9.12
Entering the Amplitude Threshold............................................................................................... 7.9.12
F-wave Histogram Window Description................................................................................................. 7.9.13
F-wave Measurement Table Window..................................................................................................... 7.9.14
Entering the Stim. Site and Recording Site................................................................................. 7.9.15
F-wave Table Window............................................................................................................................ 7.9.15
Entering the Amplitude Threshold............................................................................................... 7.9.16
F-wave Sensitivity Change.............................................................................................................................. 7.9.17

General
In the F-wave examination program, the following calculation operations are

available.
• F-wave conduction velocity measurement

• Marking
• Changing the F-wave sensitivity
• Displaying waveforms in cascade or superimposed format

7-9. CALCULATION – F-WAVE
7
F-wave Conduction Velocity Measurement
The F-wave conduction velocity (FWCV) is calculated by the equation,
F: Shortest latency of F-wave

M: Latency of M-wave
D: Distance between the stimulation site and the spinal cord
1: Anterior horn cell reflex (1 ms)
There are two ways to calculate the F-wave conduction velocity.

• Calculation with marks

When the latency cursors are set and the distance between the stimulation site 7-9
and the spinal cord is entered, the F-wave conduction velocity is automatically
calculated.
Latency 1, Latency 2, Interval and FWCV are displayed in the Latency window.
NOTE
The F-wave conduction velocity measured with cursors cannot be saved.
Only the F-wave conduction velocity measured with marks can be saved
in memory.
1. Press the LAT/AMP/TRIG key on the operation panel, or click the tool
button. The Latency cursor and Latency window appear on the wave area.
Latency window
Latency cursor
Entered
distance

2. Press the A/B key on the operation panel to select cursor A.
3. Set the cursor on the optimal onset point of the M-wave with the CURSOR
dial on the operation panel. You can also drag and move the cursor with the
mouse.
4. Press the A/B key to select cursor B.
5. Set the cursor on the optimal onset point of the F-wave with the CURSOR
dial on the operation panel. You can also drag and move the cursor with the
mouse.
6. Measure the distance between the stimulation site and the spinal cord.
7. Enter the distance in the Distance (mm) box with keyboard or by using either
the button next to the Distance (mm) box.
The F-wave conduction velocity appears in the FWCV row in the Latency
window.


When the marks are set on the waveforms and the distance between the
stimulation site and the spinal cord is entered, the F-wave conduction velocity is
automatically calculated.
The F-wave conduction velocity (FWCV) is displayed in the F-wave

Measurement Table window. The maximum, minimum, mean and standard
deviation of the F-wave conduction velocity are displayed in the F-wave
Histogram window.
1. If automatic marking function is not on, set the marks (M-Lat., F-Lat.)
manually on the waveform. Refer to “Marking After Acquisition” in this
section.
the F2 key on the keyboard. The F-wave Measurement Table window
appears.

Table Table Sens. Information Information 7-9
F1 F2 F3 F4 F5 F6 F7 F8
Measurement Table window type I
Distance (mm) box

3. Measure the distance between the stimulation site and the spinal cord.
4. Enter the distance in the Distance (mm) box with keyboard or by using either
the button next to the Distance (mm) box. The F-wave conduction
velocity appears in the FWCV column in the F-wave Measurement Table
window.

Marking



F1 F2 F3 F4 F5 F6 F7 F8
F-Amp.1: Negative peak of

each F-wave
M-Amp.1: Negative peak of M-Amp.1 F-Amp.1
the M-wave
M-Lat.: Onset point of the
M-wave which is
acquired last.
M-Amp.2: Positive peak of the F-Lat.
M-wave
F-Lat.: Onset point of each
M-Lat. M-Amp.2 F-Amp.2
F-wave
F-Amp.2: Positive peak of
each F-wave


highlighted.
one waveform.

operation panel.
marked.
7-9

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
cursor point.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
on the keyboard.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8


the Labeling Page

operation panel.
on the keyboard.

F1 F2 F3 F4 F5 F6 F7 F8

Marking Marking
F1 F2 F3 F4 F5 F6 F7 F8
on the keyboard.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
Moving a Mark
new position.

Deleting Marks 7
• Or,

Add Mark
Prev. Mark Next Mark Marking Annotation Mark Marking 7-9
F1 F2 F3 F4 F5 F6 F7 F8
Deleting All Marks

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8

F-wave Measurement Table Window
There are two types of F-wave Measurement Table windows: Type I and Type
window.
Type I: Calculation values are displayed. You can open the F-wave Histogram
window from this window.
Type II: Calculation values, F-wave histogram and superimposed waveforms are
displayed. You can open the F-wave Table window from this window.
<Type I> <Type II>
F-wave Measurement Table window
F-wave Measurement Table window

function button.

F1 F2 F3 F4 F5 F6 F7 F8


7
7-9
Stim. Site: Stimulating site (up to 20 alphanumeric characters).

Recording Site: Recording site (up to 20 alphanumeric characters).
Distance (mm): Distance between the stimulating site and spinal cord (up to 4
alphanumeric characters).
Amplitude Threshold: Threshold of F-wave. Used for F-wave Occurrence
calculation.
M-wave Latency: Latency from trigger point to M-wave latency mark (Mark 1).
The latency of the latest M-wave is displayed.
M-wave Amplitude: Maximum M-wave amplitude between Mark 2 and Mark 3.
(peak to peak M-wave amplitude)
The amplitude of the latest M-wave is displayed.
F-wave Occurrence: Ratio of number of F-waves over the threshold to all the
response waveforms. (F-wave / all response waveforms)
A waveform is recognized as an F-wave when its amplitude
is over the value set at Amplitude Threshold.
Histogram... button: Click this button to display the F-wave Histogram window.
Refer to “F-wave Histogram window”.
Sweep No.: Relation number between displayed waveform and data.
The mark “*” means that the waveform is not recognized as
an F-wave.

Annotation: Annotation for each waveform.

F-lat. (ms): Latency from trigger point to Mark 4 (F-wave latency).
F-amp. (µV): Maximum F-wave amplitude between Mark 5 and Mark 6.
(peak to peak F-wave amplitude)
F-M: Time interval between M-wave and F-wave (potential
difference between Mark 1 and Mark 4).
FWCV: F-wave conduction velocity = 2 × D / (F−M−1)
(D: Distance, F: F-wave latency, M: M-wave latency)
Stim. 1, 2: Stimulus intensity. Stim.2 is displayed for the data
measured with other instruments.

Annotation column.
1. Click the Stim. Site text box or Recording Site text box. The cursor moves to
the clicked text box.
2. Type in the stimulating site and recording site in each text box.
Entering the Distance (mm)
1. Click the Distance (mm) box. The cursor moves to the text box.
2. Type in the distance between the stimulating point and the spinal cord.
Entering the Amplitude Threshold
1. Click the button on the right of the Amplitude Threshold box. The drop
down list opens.
2. Select the desired value in the list.

F-wave Histogram Window Description 7

The minimum, maximum, mean and standard deviation of each F-wave are
automatically calculated.
To display the F-wave Histogram window, click the Histogram... button on the
F-wave Measurement Table window.
Mean, standard deviation, minimum and

maximum for each calculation item
7-9
F-latency (ms): F-wave latency.

F-M Latency (ms): Time interval between M-wave and F-wave onset marks.
F-ratio: Ratio of conduction time from stimulating site to related
segment of spinal cord and to innervated muscle =
(F−M−1) / (2 × M)
(F: F-wave latency, M: M-wave latency)
F/M Amp. Ratio (%): Ratio of F-wave amplitude to M-wave amplitude
Count box: Set the maximum number of F-wave occurrence for the
Y-axis of the histogram.
F-latency (ms) box: Set the maximum F-wave latency for the X-axis of the
histogram.
Latency Histogram Vertical axis: Number of F-wave occurrences. (The
maximum value is set at the Count box.)
Horizontal axis: F-wave latency (The maximum value
is set at the F-latency box.)


Number of acquired waveforms
Preset number of F-wave Table button
waveforms to be acquired Opens the F-wave Table window.
Rec. No.
Stimulation settings
Mean, standard deviation,

minimum and maximum for
each calculation item
Histogram
Amplitude of a waveform is
shown as a bar.
Superimposed waveforms
(Baseline for waveforms are adjusted into the same level.)
Stim. Site: Stimulating site (up to 20 alphanumeric characters).

Recording Site: Recording site (up to 20 alphanumeric characters).
Distance (mm): Distance between the stimulating site and spinal cord (up
to 4 alphanumeric characters).
M-wave Latency: Latency from trigger point to M-wave latency mark
(Mark 1).
The latency of the latest M-wave is displayed.
M-wave Amplitude: Maximum M-wave amplitude between Mark 2 and Mark
3. (peak to peak M-wave amplitude)
The amplitude of the latest M-wave is displayed.

F-wave Occurrence: Ratio of number of F-waves over the threshold to all the 7
response waveforms. (F-wave/all response waveforms)
A waveform is recognized as an F-wave when its
amplitude is over the value set at Amplitude Threshold.
Count box: Set the maximum number of F-wave occurrences for the
Y-axis of the histogram.
F-latency (ms) box: Set the maximum F-wave latency for the X-axis of the
histogram.
Latency Histogram Vertical axis: Number of F-wave occurrences. (The
maximum value is set at the Count box.)
Horizontal axis: F-wave latency (The maximum value is
set at the F-latency box.)
Selecting the Rec. No.
number.
7-9
1. Click the Stim. Site text box or Recording Site text box.
2. Type in the stimulation site and recording site in each text box.
F-wave Table Window

To display the F-wave Table window, click the F-wave Table button on the F-
wave Measurement Table window.

Rec. No.: Recording number

Close button: Closes the F-wave Table window.
STIM settings: Stimulation settings
Sweep No.: Relation number between displayed waveform and data.
The mark “*” means that the waveform is not recognized
as an F-wave.
F-lat. (ms): Latency from trigger point to Mark 4 (F-wave latency).
F-amp. (mV): Maximum F-wave amplitude between Mark 5 and Mark
6. (peak to peak F-wave amplitude)
F-M: Time interval between M-wave and F-wave (potential
difference between Mark 1 and Mark 4).
Stim. 1: Stimulus intensity
Stim. 2: Stimulus intensity (appears only for the data measured
with other model instruments.)
Amplitude Threshold: Threshold of F-wave. Used for F-wave Occurrence
calculation.
Selecting the Rec. No.
number.
Entering the Amplitude Threshold
1. Click the button on the right of the Amplitude Threshold box. The drop
down list opens.
2. Select the desired value in the list.

7
F-wave Sensitivity Change
The display gain (sensitivity) of the F-wave (right half of the wave area) can be
temporarily changed on the Stop window.
1. Click the Second Sens. function button or press the F4 key on the keyboard.
(The Second Sens. function button is pressed.)
Measurement Cascade Second Examination Nerve Patient

Marking Superimpose
Table Display Sens. Information Input Information
F1 F2 F3 F4 F5 F6 F7 F8
2. Adjust the sensitivity with the VERTICAL RANGE ↓ / ↑ key on the

operation panel.
When adjusting the sensitivity of the M-wave, select the Second Sens.
7-9
function button (The Second Sens. function button is unpressed), then adjust
the sensitivity with the VERTICAL RANGE ↓ / ↑ key on the operation
panel.

Saving Data on Disk
were acquired.
on the Stop window.

Marking Superimpose
F1 F2 F3 F4 F5 F6 F7 F8

7
manual for details.
the Stop window.

Marking Superimpose
F1 F2 F3 F4 F5 F6 F7 F8

7-9

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8

Table window.

Section 7-10 Measurement – H-reflex 7
General............................................................................................................................................................ 7.10.2
Features................................................................................................................................................ 7.10.2
Preparation...................................................................................................................................................... 7.10.3
Electrode Attachment and Connection.................................................................................................. 7.10.3
Measurement................................................................................................................................................... 7.10.5
Entering the Nerve Name...................................................................................................................... 7.10.5
Copying the Acquired Waveforms to the Stop Window......................................................................... 7.10.7
Copying Procedure..................................................................................................................... 7.10.7
Deleting Waveforms.............................................................................................................................. 7.10.8
7-10
Printing Data......................................................................................................................................... 7.10.8

General
This program measures H-reflex. The H-reflex is a monosynaptic reflex mediated

by the Ia sensory fibers, which synapse with alpha motor neurons and their
axons.
Features
• Up to 9999 sweep waveforms can be acquired for each channel. The
measurement results and the waveforms can be saved on the hard disk.
• The data for up to 26 stages can be displayed in the Measurement Table
window.
• The latency, amplitude, and the maximum amplitude with latency of each
M-wave and H-wave can be automatically calculated and displayed in the
• Superimposed waveforms and the Intensity-Amplitude graph are displayed on
the H-reflex Measurement Table window (type II).

7-10. MEASUREMENT – H-REFLEX
7
Preparation

following page.

amount of Skinpure skin preparation gel to reduce artifact. Wipe the skin 7-10
6. Attach the active and reference electrodes with paste to the optimal sites
as shown on the following page. Use the disk electrode for the active and
reference electrodes.
NOTE

Stimulation site
Tibial nerve at the popliteal fossa
Grounding electrode
CH1(−) Active electrode

on the soleus or gastrocnemius
CH1(+) Reference electrode

Medial surface of the Achilles tendon
Grounding electrode

7
Measurement

2. Select the H-reflex program on the Main Menu window. The H-reflex
window are displayed in the H-reflex examination program window.
7-10

F1 F2 F3 F4 F5 F6 F7 F8


output and display the waveforms (stimulation rate is fixed at 1 Hz).
4. Place the stimulating electrode on the stimulation site. Put the (−) side
proximal to the (+) side. The black marked side of the NM-420S surface
5. While checking the waveforms, turn the stimulation intensity dial on the
operation panel to gradually increase the stimulation intensity until the H-
wave disappears.
The response waveform elicited by electric stimulation changes as below.
low
(1) H-wave appears
Stimulus (2) The H-wave amplitude increases and M-wave appears.
Intensity (3) The H-wave amplitude decreases and the M-wave
amplitude increases.
(4) H-wave disappears and the M-wave amplitude reaches the maximum level.
high
6. Press the STOP key on the operation panel. The wave window changes to the
Gather window and the preset number of acquired waveforms are displayed
on the Gather window. (The number of waveforms is set at Preset Count on
the Acquisition page of the Set Conditions window.)
NOTE
Acquired waveforms are displayed on the Gather window only when
Store Raw Wave is set to Gather on the Acquisition page of the Set
Conditions window.
7. Copy the necessary waveforms to the Stop window and save them.
For the procedure, refer to the “Copying the Acquired Waveforms to the
Stop Window” section.

Copying the Acquired Waveforms to the Stop Window 7

To save, set marks and do calculations, copy the acquired waveforms on the
Gather window to the Stop window.
If the Gather window is not displayed, first display the Gather window with the
following procedure.
1. Click the function button to display the next function buttons.
Measurement Condition Processing Examination Nerve Patient

Marking Superimpose
F1 F2 F3 F4 F5 F6 F7 F8 F9
2. Click the Gather Wave function button or press the F2 key on the keyboard.
Second Gather
Sens Wave
F1 F2 F9
The Gather window opens. The latest waveform is displayed at the top. 7-10
Copying Procedure
1. Select the waveforms to copy.

i) On the Gather window, select the stage with the button.
ii) Align an arrow to the desired waveform by pressing the SELECT ↓ ↑
key.
iii) Click the Select Wave function button or press the F1 key on the
keyboard. The selected waveform is different color.
Select Copy to Superimpose Second Patient End

Wave Stop Screen Sens. Information Gather
F1 F2 F3 F4 F5 F6 F7 F8
2. Click the Copy to Stop Screen function button or press the F2 key on the
keyboard. The selected waveform is copied to the Stop window.
Select Copy to Superimpose Second Patient End

Wave Stop Screen Sens. Information Gather
F1 F2 F3 F4 F5 F6 F7 F8
The Gather window closes and the Stop window is displayed. The copied
waveforms are given names A1, B1, C1,... respectively. (This is the stage
name.)
of the Set Conditions window, the waveforms on the Stop window are
automatically temporarily saved in memory as one stage.

NOTE
If you delete the A1 waveform on the Stop window, all acquired
waveforms in the Gather window are deleted.
To close the Gather window, click the End Gather function button or press
the F8 key on the keyboard.

• Marking
• Printing the data
Deleting Waveforms
selected.
selected.
deletion appears.
Saving Data on Disk

Printing Data

Section 7-11 Calculation – H-reflex 7
General............................................................................................................................................................ 7.11.2
Marking............................................................................................................................................................ 7.11.3
Auto Marking During Acquisition........................................................................................................... 7.11.3
Marking After Acquisition...................................................................................................................... 7.11.3
Setting One Mark at a Time........................................................................................................ 7.11.3
Setting Multiple Marks Automatically According to the Settings on the Labeling Page............... 7.11.5
Moving a Mark....................................................................................................................................... 7.11.5
Deleting Marks...................................................................................................................................... 7.11.6
Deleting an Individual Mark......................................................................................................... 7.11.6
Deleting All Marks....................................................................................................................... 7.11.6
H-reflex Measurement Table Window.............................................................................................................. 7.11.7
H-reflex Measurement Table Window.................................................................................................... 7.11.9 7-11
Annotating a Waveform............................................................................................................. 7.11.10
Entering the Stim. Site and Recording Site............................................................................... 7.11.10
Measurement Table Window Type II Description........................................................................................... 7.11.11
H-reflex Measurement Table Window.................................................................................................. 7.11.11
Annotating a Waveform............................................................................................................. 7.11.12
Intensity Amplitude Graph......................................................................................................... 7.11.12
Saving Data on Disk...................................................................................................................................... 7.11.13
Condition Table Window................................................................................................................................ 7.11.13
Annotating a Waveform................................................................................................................................. 7.11.14

General
In the H-reflex examination program, the following calculation operations are

available.
• Marking

7-11. CALCULATION – H-REFLEX
7
Marking
Marks can be set automatically or manually. When the waveforms are marked,
waveform measurement starts automatically and the results can be displayed in
the H-reflex Measurement Table window.



1. Click the Marking function button on the Stop window or press the F1 7-11

F1 F2 F3 F4 F5 F6 F7 F8
Vertical cursor


highlighted.
one waveform.

operation panel.
marked.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
cursor point.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
on the keyboard.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8


the Labeling Page

operation panel.
on the keyboard.

F1 F2 F3 F4 F5 F6 F7 F8

Marking Marking
F1 F2 F3 F4 F5 F6 F7 F8
7-11
on the keyboard.

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
Moving a Mark
new position.

Deleting Marks
• Or,

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8
Deleting All Marks

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8

7
H-reflex Measurement Table Window
There are two types of H-reflex Measurement Table windows: Type I and Type II. Select either Type I or Type II on the
Labeling page on the Set Conditions window.
Type I: Calculation values for each waveform are displayed.

Type II: Calculation values for each waveform are displayed. The Intensity-Amplitude graph and superimposed waveforms
are also displayed on the same window. The Routine window or HM Latency window can be selected on the NCS
<Type I> <Type II>
H-reflex Measurement Table window - Routine
7-11
H-reflex Measurement Table window

- H/M Latency
H-reflex Measurement Table window

function button.

F1 F2 F3 F4 F5 F6 F7 F8



7
7-11
Stim. Site: Stimulation site (up to 20 alphanumeric characters)

M-wave Amp. Max: The maximum amplitude of M-wave
M-wave Latency: Latency of the M-wave which has maximum amplitude.
H-wave Amp. Max: The maximum amplitude of H-wave
H-wave Latency: Latency of the H-wave which has maximum amplitude.
H/M Ratio: Ratio of H-wave maximum amplitude to M-wave
maximum amplitude
No.: Reference number of the waveform displayed.
M-lat.: Latency from trigger point to M-wave Mark 1
M-amp.: Potential difference between M-wave amplitude marks
(Potential difference between Mark 2 and Mark 3)
H-lat.: Latency from trigger point to H-wave Mark 4
H-amp.: Potential difference between H-wave amplitude marks
(Potential difference between Mark 5 and Mark 6)
Stim.1, 2: Stimulus intensity (Stim 2 is displayed when reading the
data measured with other instruments.)


Annotation column.
1. Click the Stim. Site text box or Recording Site text box. The cursor moves to
the clicked box.
2. Type in the stimulation site and recording site in the boxes.

7

Stimulation site (up to 20 Recording site (up to 20
alphanumeric characters) alphanumeric characters) Stimulation settings
Sensitivity
Annotation for each

waveform
Reference number of the

waveform displayed.
7-11
Superimposed waveforms
(Baseline for waveforms
are adjusted into the same
level.) Intensity Amplitude graph
H/M Ratio: Ratio of H-wave maximum amplitude to M-wave maximum amplitude

H/M Threshold: Proportion of H-wave to M-wave stimulation current
M-lat.: Latency from trigger point to M-wave Mark 1
M-amp.: Potential difference between M-wave amplitude marks (Potential
difference between Mark 2 and Mark 3)
H-lat.: Latency from trigger point to H-wave Mark 4
H-amp.: Potential difference between H-wave amplitude marks (Potential
difference between Mark 5 and Mark 6)
Stim.1, 2: Stimulus intensity (Stim 2 is displayed when reading the data measured
with other instruments.)


Annotation column.
Intensity Amplitude Graph
The relation between the stimulation intensity and the amplitude is shown in the
graph. According to the marks on the waveform, H-wave and M-wave are plotted
with the following symbols.
M-wave
H-wave
The horizontal axis is the stimulation current, and the vertical axis is the
amplitude of H-wave and M-wave. The scales for both axis are adjusted
automatically and cannot be changed by users.

7
Saving Data on Disk
were acquired.
on the Stop window.
7-11

Marking Superimpose
F1 F2 F3 F4 F5 F6 F7 F8

manual for details.
the Stop window.

Marking Superimpose
F1 F2 F3 F4 F5 F6 F7 F8

Add Mark Marking
F1 F2 F3 F4 F5 F6 F7 F8

Table window.

Section 7-12 Measurement – Blink 7
General............................................................................................................................................................ 7.12.2
Features................................................................................................................................................ 7.12.2
Preparation...................................................................................................................................................... 7.12.3
Electrode Attachment and Connection.................................................................................................. 7.12.3
Measurement................................................................................................................................................... 7.12.5
Entering the Nerve Name...................................................................................................................... 7.12.5
Deleting Waveforms.............................................................................................................................. 7.12.7
Printing Data......................................................................................................................................... 7.12.7
7-12

General
Features
This examination measures polysynaptic reflex (orbicularis oculi muscle reflex)
consisting of two components, the afferent of the trigeminal sensory branches
and the efferent of facial nerve motor fibers.

displayed on the window. (4 channels × 26 stages)
• Up to 9999 sweep waveforms can be acquired for each channel.
• The measurement results and the waveforms can be saved on the hard disk.
• The relation between the mark position and the normative range is easy to see
on the Blink Measurement Table window.
• Waveforms which are averaged after rectification are displayed on the Blink

7-12. MEASUREMENT – BLINK
7
Preparation

1. Connect the active and reference electrode leads to the electrode jacks
as shown on the following page. Use disk electrodes for the active and
reference electrodes.
2. Connect the NM-550B Ground Electrode (disk type) lead to the E jack.

7-12
6. Attach the active and reference electrodes with paste to the optimal sites as
shown on the following page.
7. Attach the NM-550B ground electrode with Elefix.
NOTE
• When the stimulating electrode position is optimum, there is less
stimulating artifact. To find the optimum position of the stimulating
electrode, turn the stimulating electrode (+ anode) while the stimulating
electrode (− cathode) is fixed.


The stimulating electrode is placed on the supraorbital foramen. Electrical
stimulation is given to the supraorbital nerve. Stimulation is single. Repeat
several stimulations and record response waveforms.
The active electrode is placed two-thirds of the distance from the outer edge of
the lower orbicular muscle of eye, and the reference electrode is placed on the
roots of nose on the left and right sides. Simultaneous recording is performed at
the part of bilateral symmetry (2 channel measurement). Stimulation is given to
each side.

SOMATO control box

Ground Electrode
CH1 ( ) Active electrode

CH1 () Reference electrode
CH2 () Reference electrode
CH2 ( ) Active electrode

CH1 (−) Active electrode
CH1 (+) Reference electrode
CH2 (−) Active electrode
CH2 (+) Reference electrode
Grounding electrode

7
Measurement

2. Select the Blink program on the Main Menu window. The Blink examination
program window opens. The wave area and Nerve Table window are
displayed in the Blink examination program window.
When using the Foot switch for stimulation, check the setting of Foot Switch
Right on the Misc. page of the Set Conditions window. The factory default
setting is Single. When the “R” foot switch is pressed, the single stimulation
is performed.
7-12


F1 F2 F3 F4 F5 F6 F7 F8

NOTE
Ask the patient to not blink during recording.
2. Check that the stimulus intensity is set to 0 mA. If not, press the Reset key
3. Turn the stimulation intensity dial to increase the stimulation intensity.

Usually, the intensity is set between 15 to 30 mA.
4. Place the stimulating electrode on the stimulation site and prepare for
the stimulation output. The black marked side of the NM-420S surface

5. Output a single stimulation.
When using the foot switch:
The setting of Foot Switch Right is set to Single in the factory default
setting. Press the “R” foot switch. The single stimulation is output and the
two channel response waveforms appear on the Stop window.
When using the SOMATO control box:

Press the stimulation ON/OFF button on either side. The single stimulation is
output and the two channel response waveforms appear on the Stop window.
6. Save the waveform temporarily in memory.

the Set Conditions window, the waveforms are automatically temporarily
saved in memory.
7. Repeat the measurement several times under the same settings. Take 3 to 5
second interval between measurements.
The acquired waveforms are superimposed on the temporarily saved
waveforms.

• Marking
• Printing the data

Deleting Waveforms 7
selected.
selected.
deletion appears.
3. Check that the waveform selection is correct, and press the ERASE key. The 7-12
Saving Data on Disk

Printing Data

Section 7-13 Calculation – Blink 7
General............................................................................................................................................................ 7.13.2
Marking............................................................................................................................................................ 7.13.3
Marking After Acquisition...................................................................................................................... 7.13.3
Moving a Mark....................................................................................................................................... 7.13.5
Deleting Marks...................................................................................................................................... 7.13.5
Deleting an Individual Mark......................................................................................................... 7.13.5
Deleting All Marks....................................................................................................................... 7.13.5
Evoked Measurement Table - Latency Window..................................................................................... 7.13.8
Evoked Measurement Table - Mark Pair Window.................................................................................. 7.13.9
Setting Pairs.............................................................................................................................. 7.13.10
Entering the Waveform Number................................................................................................ 7.13.10
Measurement Table Window Type II Description........................................................................................... 7.13.11 7-13
Blink Measurement Table Window....................................................................................................... 7.13.11
Marking for Calculating with the Blink Measurement Table Window ........................................ 7.13.12
Entering the Stage.................................................................................................................... 7.13.12
Rectified Average Wave............................................................................................................ 7.13.12
Displaying the Normative Range............................................................................................... 7.13.13
Creating the CSV File............................................................................................................... 7.13.13
Saving Data on Disk...................................................................................................................................... 7.13.15
Condition Table Window................................................................................................................................ 7.13.15
Annotating a Waveform................................................................................................................................. 7.13.16

General
In the Blink examination programs, the following calculation operations are

available.
• Marking
• Annotating waveforms

7-13. CALCULATION – BLINK
7
Marking
When marks are set on the waveform, the latency and amplitude are calculated.
The calculation values are displayed on the Measurement Table window.

Set one mark at a time on the waveform after acquisition.

F1 F2 F3 F4 F5 F6 F7 F8
7-13
Vertical cursor

highlighted.
one waveform.

operation panel.
marked.
3) Click the function button of the mark label you want to set, or press the
function key on the keyboard corresponding to the mark label. The mark is
set on the cursor point. The latency (ms) at the point is displayed under the
selected mark label on the function button.
a) Click the function button or press the F9 key on the keyboard to
display the next function buttons.

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8
c) Click the Add Mark function button or press the F1 (Add Mark) key on
the keyboard. The mark is set at the cursor point.

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8
on the keyboard.

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8

Moving a Mark 7
the “Marking After Acquisition” procedure. The selected mark moves to the
new position.
Deleting Marks
There are two procedures.
• When the mark label you want to delete is on the function button, you can also
• Or,
7-13

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8
Deleting All Marks

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8

There are two types of Evoked Measurement Table windows, Type I and Type
window.
can be displayed in the Measurement Table window.
Type II: The Blink Measurement Table window is displayed. On the Blink
Measurement Table window, waveforms which are averaged after
rectification are displayed.
<Type I> <Type II>
Evoked Measurement Table-Latency window
Blink Measurement Table window

Evoked Measurement Table-Mark Pair window

function button.

Marking Superimpose
F1 F2 F3 F4 F5 F6 F7 F8


7-13

Evoked Measurement Table - Latency window and the Evoked Measurement
Table - Mark Pair window open.
Show ND check box

(The waveforms which are displayed in the wave area
are automatically displayed on the Evoked Measurement
Table-Latency window in wave number order.)
Stim.1, Stim.2: Stimulation output (electrical stimulation output) during
the measurement
Stim.2 is displayed only for the data measured with
other model instruments.
Show ND check box: Check this box to display the Normative data columns.
Normative data column: Enter normative data in this column.
You can enter normative data in a box.

1. Click the Show ND check box on the Evoked Measurement Table-Latency
window. Two blank rows appear for entering normative data.
2. Click the box to enter normative data and enter normative data with the
keyboard. The entered normative data is automatically saved in the memory
and applied to the next measurement.

Annotating a Waveform 7
1. Click the Annotation box to enter an annotation.

To open the annotation list, click the on the right of the Annotation
column.

Mark Pair From box
Mark Pair To box
Type box
No. box
7-13

When two waveform numbers (for example, A1-B1) are input, the
two rows above.
When the items differ (for example, Interval and Area), or only one

Setting Pairs
make a pair.
Mark Pair From box

Mark Pair To box
R1 iR2a
C1
Calculation value
To enter the waveform number in the No. box, use the keyboard. When you
set two waveform numbers (only for Interval), enter waveform numbers in the
format “A1-B1”.

7
Blink Measurement Table window opens.
can be displayed in the Blink Measurement Table window.
Blink Measurement Table Window

Upper row: area between iR2a and cR2a
Lower row: area between cR2a and cR2b
Upper row: difference between the latencies at iR2a and iR2b

Lower row: absolute value of the difference between the
latencies at cR2a and cR2b
Amplitude of the peak immediately after R1 “Left” row: latency at L-D-Lat

“Right” row: latency at R-D-Lat
Difference between the latencies at iR2a and cR2a
for each stimulation side respectively
Sensitivity Stimulation intensity Stimulation settings
Upper row: 7-13

latency at iR2a
Lower row:
latency at cR2a
Latency at R1
(latency at R)
(L-D-Lat. latency)
(latency at R)
(R-D-Lat. latency)
Stimulation side of
each stage
Calls up a CSV
file
4 waveforms which
are averaged after
rectification
Refer to “Displaying the

Normative Range”

Marking for Calculating with the Blink Measurement Table Window
To calculate waveforms with the Measurement table window type II, set marks
and enter stages in the Stim. Site column as shown in the example below.
Example: Acquiring stage A to E by left side stimulation and stage F to L by

right side stimulation
Set marks as shown in the figure below and enter “A-E” in the Stim.Site Left
column, and enter “F-L” in the Stim.Site Right column.
Ch1: Recording at the left side

Ch2: Recording at the right side
E1, L2: Response of the orbicular muscle of eye by stimulating the facial nerve
at the retroauricular site.
Left side stimulation (Blink) Right side stimulation (Blink)
iR2a iR2b cR2a cR2b

R1 G1 to K1
A1 to E1
cR2a iR2a iR2b

cR2b R1
A2 to E2 G2 to K2
Left side stimulation Right side stimulation
L-D-Lat R-D-Lat
F1 L2
Entering the Stage
To enter more than one stage name in the column, put “-” between the first stage
and the last stage.
The figure on the left means that waveforms of stages A to E were acquired by
stimulating the left side, and waveforms of stages F to L by stimulating the right
side.
Rectified Average Wave
Shows four waveforms which are averaged after rectification.

Wave 1: Ch 1, left side
Wave 2: Ch 2, left side
Wave 3: Ch 1, right side
Wave 4: Ch 2, right side

Displaying the Normative Range 7

By selecting a CSV file in the Normative Data file text box, the latencies of R1,
R2 Ipsilateral and R2 Contralateral are displayed in the Normative Range graph.
Refer to the “Creating a Normative Data File” to create and save the CSV file.
Normative range (normative value ±2SD):

Mark position: (left side stimulation)
(right side stimulation)
When the mouse is set to the bar or mark, the calculation value and the
normative value are displayed.
Creating the CSV File
You can create a normative data file. Using a Microsoft Excel spreadsheet is
recommended. Bars in the Normative Range (+/−2SD) column are displayed
based on the normative data file.
7-13

First line: Title
Second line: Comment

Third line:
the normative range
Normative value and standard deviation
of the latency of R2 Ipsilateral waveform
Normative value and standard
deviation of the latency of R1 Normative value and standard deviation
waveform of the latency of R2 Contralateral
waveform


First line: Title
Second line:
Comment
Third line: - The contents are the same as that of the Excel
spreadsheet.
the normative range
- Words or data must be separated by commas only.
Never put a space or tab before or after a comma.

Use any file name.

7
Saving Data on Disk
were acquired.
on the Stop window or press the F3 key on the keyboard.

F1 F2 F3 F4 F5 F6 F7 F8
7-13

manual for details.
the Stop window.

F1 F2 F3 F4 F5 F6 F7 F8
3. Click the Wave Annotation function button or press the F5 (Wave

Annotation) key on the keyboard to open the Wave Annotation window.

Add Mark
F1 F2 F3 F4 F5 F6 F7 F8

Table window.

Section 7-14 NCS (Nerve Conduction 7
Studies)
General............................................................................................................................................................ 7.14.2
Setup..................................................................................................................................................... 7.14.2
Operation Procedure....................................................................................................................................... 7.14.3
Settings for Each Examination Program................................................................................................ 7.14.3
Operation Procedure............................................................................................................................. 7.14.8
When the Examination Order is Set............................................................................................ 7.14.8
When the Examination Order is Not Set .................................................................................... 7.14.9
Starting Measurement ............................................................................................................. 7.14.10
Marking..................................................................................................................................... 7.14.11
Changing the Examination Type................................................................................................ 7.14.11
Changing the Examination Side................................................................................................ 7.14.11
Selecting Other Nerve............................................................................................................... 7.14.11
MCS/SCS Measurement Table Window.............................................................................................. 7.14.12
F-wave Measurement Table Window................................................................................................... 7.14.15
Saving Data on Disk............................................................................................................................ 7.14.17
Printing a Report................................................................................................................................. 7.14.17
7-14

General
Motor Nerve Conduction Study (MCS), Sensory Nerve Conduction Study (SCS)
and F-wave examination can be performed on the NCS examination program.
• A nerve name and its measurement settings can be registered. You can set the
measurement settings by specifying the registered nerve name.
• Up to 42 routine examinations can be set by selecting a nerve, side and
examination program as a routine protocol.
• The measurement result can be displayed on the measurement table window.
• The measurement result can be printed as an NCS report with the Excel.
• The normative data can be used for the MCS and SCS examination.
Setup
and settings.
2. Select the NCS program on the Main Menu window. The NCS examination
program window opens. The wave area and Nerve Table window are
displayed in the NCS examination program window.
operator’s manual and “Settings for Each Examination Program” in this
section.
4. Prepare the recording electrode leads, grounding electrode lead and

stimulator. Refer to the setup procedure for each examination program.

7-14. NCS (NERVE CONDUCTION STUDIES)
7
Operation Procedure

Nerve 1 to 8 Pages
You can set the MCS, SCS and F-wave measurement settings for up to 7 nerves.
By specifying the nerve name with the function button, the measurement settings
for the selected nerve are automatically selected. In the Nerve 8 page, there is
no nerve box to specify the nerve name. When measuring a nerve that is not
set in the Nerve 1 to 7 pages, the measurement settings in the Nerve 8 page are
automatically selected.
7-14

Item Description
Nerve Select the nerve name for the measurement. By specifying the nerve name,
the measurement settings are automatically selected.
MCS, SCS, F-wave Select the measurement program for the selected nerve.
Channels selection list box Select the channel to acquire the waveforms.
Electrode (−) Select a pair of electrode names to acquire the waveforms.
Electrode (+)
Sens Select the amplifier sensitivity.
Hi-cut Select the high-cut filter frequency of the amplifier.
Lo-cut Select the low-cut filter frequency of the amplifier.
Analysis (/div) Select the analysis time for horizontal length (scale/division) for trigger
sweep and average.
Count (SCS, F-wave only) SCS: Select the number of waveforms to average.
F-wave: Select the number of waveforms to acquire.
Reject (SCS only) Select the amplitude threshold (div) to select the acquired waveforms for
threshold, it is not included in averaging.
Table (MCS, SCS only) For the MCS and SCS examination, the measurement table can be edited.
Edit Table button: Opens the Edit Table to enter the site, segment, distance
and normative value (NR/SD) for each nerve.
Stim. Site (F-wave only) Enter the stimulation site for the nerve.
Recording site (F-wave only) Enter the recording site for the nerve.
ND:F-Lat,(F-wave only) Enter the normative F-wave latency for the nerve.
ND:FWCV (F-wave only) Enter the normative F-wave conduction velocity for the nerve.
Cascade Display in Check this box to display the cascaded waveforms on the Monitor/Sweep
(F-wave only) window and/or Stop window. The number of waveforms displayed on one
screen can be set in the No. of Disp list box.
Histogram (F-wave only) Select the maximum horizontal and vertical scale to display the F-wave
histogram.
Dual Sens. (F-wave only) 2nd Sens.: Select the waveforms second period amplifier sensitivity.
Smoothing points: Select the number of sampling points.
Edit Table dialog box
The following normative data can be entered.

Latency 1, Latency 2, Amplitude, Duration, Area
The normative data of the latency 1, latency 2 and amplitude are displayed in the
Measurement Table window - Type II. The normative data of the Duration and
Area are for other applications.

Labeling Page 7
Select the marks settings set on the waveform.
Item Description
Auto Marking Select whether or not to automatically set marks on the
waveform.
Auto Magnify Select the waveform display sensitivity while marking.
(MCS, SCS only)
Auto Advance Check this box to automatically select the next
(MCS, SCS only) waveform in Fast Marking mode. Refer to “Operation
Procedure - Marking”.
Measure Table Type Select the type of the Measurement Table window.
(MCS, SCS only)
F-wave Measure Mode Select the type of the Measurement Table window. 7-14
(F-wave only)
For other settings, refer to the “Labeling Page” in Section 5 of the MEB-9400
operator’s manual.

NCS Page
Select the method to set the mark on the waveform.
Item Description
Auto Mark Detect Select the algorithm to detect a mark point.
Peak-Bottom: Detects the positive peak and
negative peak as a mark point after
detecting the rising point.
Window: Conventional mark detection method
Table Sequence Opens the Table Sequence dialog box to select the
examination order for the routine examination.
Single Stim. Check this box to apply single stimulation when
the STIM/SWEEP button is pressed. After the
stimulation, the screen changes to the STOP window.
Temp or Normative Data Select to display the normative data or temperature
for each segment in the NR (+/−2SD) column.
Stim reset timing Select the timing to set the stimulation intensity to
zero.
Reset button: when the RESET key is pressed.
Store Timing: when the waveform is saved (The
STORE key is pressed).
Trace Fixed Mode Check this box when the examination order is not
determined. You can set the examination site in the
NCS examination window before measurement.

Table Sequence dialog box 7

You can select the examination order for the routine examination on the Table
Sequence dialog box. To change the setting, select the setting. The list box opens.
7-14

Operation Procedure
The operation procedure is different depending on whether the examination order
is set in the Test Sequence dialog box or not. The examination order is preset in
the factory.
When the Examination Order is Set
When the NCS examination program starts, the NCS examination program
window opens. The wave area and Nerve Table window are displayed in the
NCS examination program window.
The examination order set in

the Test Sequence dialog box
• To do the next examination, select the Next Test function button or press the
MUSCLE/TEST ↓ ↑ key on the operation panel or select the next examination
in the list with the mouse.
• To measure the nerve or examination side that is not set in the Test Sequence
dialog box,
1) Select the Exit Sequence function button with the mouse. The Nerve Table
window opens.
2) Select the nerve name and examination side, and click the OK button.
3) Select the examination with the function button.
• To return to the test sequence, click the Return Sequence function button with
the mouse.
When the Examination Order is Not Set 7

When all items in the Test Sequence dialog box are set to “OFF”, the Test List
box is only displayed on the NCS window.
1. Select the nerve name with the function button. When the nerve name is
not displayed on the function button, select the Other Nerve button with the
mouse to display the nerve name.
2. Select the F3 function button to select the examination side. The currently
selected side is displayed on the F3 function button.
7-14
3. Select the examination with the function button.

Starting Measurement
For each operation procedure, refer to the “Operation Procedure” section for
each examination.
NCS Examination Program Window - MCS/SCS
Settings set in the Set

Conditions window - Nerve page
NCS Examination Program Window - F-wave

Marking 7
Marks can be set on the waveform automatically or manually. For marking, refer
to “Common Operation” and “Settings for Each Examination Program - Mark
Page” in this section.
MCS/SCS: Up to 4 marks for each examination
F-wave: Up to 6 marks for each examination
Fast Marking Mode

In Fast Marking mode, the Latency 1, Latency 2, Amplitude 1 and/or Amplitude
2 marks are automatically set on the waveform.
1. Press the LAT/AMP/TRIG key on the operation panel to enter the Fast
Marking mode.

operation panel.
3. Turn the CURSOR dial to move the vertical cursor to the rising point of the
waveform.
4. Press the A/B key on the operation panel. The Latency 1, Latency 2,
Amplitude 1 and/or Amplitude 2 marks are automatically set on the
waveform.
5. Repeat steps 2 to 4 for the waveforms to be marked. When the Auto Mark
Advance check box (MCS and SCS measurement only) is checked in the
Set Conditions window - Labeling page, the next waveform is automatically
selected. 7-14
6. Press the LAT/AMP/TRIG key to exit Fast Marking mode.
Changing the Examination Type

To change the examination type after examination without changing the nerve
name and examination side, select the examination with the function button.
Changing the Examination Side

To change the examination side, select the F3 function button. The currently
selected side is displayed on the F3 function button.
Selecting Other Nerve

To select another nerve, select the F2 function button. The selectable nerve name
is displayed on the function button.
MCS/SCS Measurement Table Window

Measurement Table Type I
Number of averaged waveforms Number of rejected waveforms
Preset number of Sensitivity Stimulation intensity Stimulation settings

Comment (stimulation site)
Waveform order on the

wave window
Paired waveforms
The number is waveform order
on the wave window. The site
can be selected from the list
box. To open the list box, click
the segment.
Waveforms on the wave

window are superimposed.
Examination list
M: MCS, S: SCS, F: F-wave
The examination window can
be displayed by clicking the
Lat.: Latency from the trigger point to Lat. 1 (Mark 1) examination
Area: Area between Lat. 1 (Mark 1) and Lat. 2 (Mark 2) which is calculated according to
the Area Mode on the Labeling page of the Set Conditions window
Stim: Final stimulation intensity per stimulation channels.
NCV: Motor nerve conduction velocity

Dist.: Distance between the waveforms in the Segment column (unit:mm)
Interval: For single waveform, time interval between the stimulating point and Lat.1 (Mark
1). For paired waveforms, time interval between the respective Lat. 1 (Mark 1) on
paired waveforms (segment waveform)
CCV: Motor nerve conduction velocity compensated for skin temperature

Measurement Table Type II 7

Normative data entered in the
Edit Table dialog box
7-14

Trace Fixed Mode
Use Trace Fixed Mode when the examination order is not determined. When the Trace Fix Mode check
box is checked, stages A1 to F1 are displayed on the Measurement Table window. Before measurement,
you can select the stage where the waveform is saved with the ALL/INDV key and SELECT ↓ ↑ key on the
operation panel or mouse operation. The selected stage is surrounded by a rectangle. In the above example,
the waveform is acquired in stage B1. After waveform acquisition, when another stage is selected, the
acquired waveform is automatically saved. To acquire another waveform to in a stage where a waveform
has already been saved, delete the saved waveform with the Erase button on the tool bar.

F-wave Measurement Table Window 7

F-wave Cursor Measure Window
1. Enter the stimulation site with up to 20 characters.
2. Enter the recording site with up to 20 characters.
3. Enter the distance between the stimulation site and
spinal cord with up to 4 characters.
4. Enter the number of F-waves to calculate the F-wave %
(ratio of number of F-waves to response waveforms).
ND:
Normative data entered
in the Set Conditions
window - Nerve page.
The F-wave conduction velocity is

calculated by:
2 × distance
F-wave latency - M-wave latency -1
The F Ratio is calculated by:

F-wave latency - M-wave latency -1
2 × M-wave latency
7-14
5. Set the cursor on the rising point of the M- 6. Set the cursor on the rising point of the F-
wave. The M-wave latency from the trigger wave. The F-wave latency from the trigger
point to the cursor point is calculated. point to the cursor point is calculated.

F-wave Mark Measure Window
Minimum, maximum and

mean for each calculation F-wave Table button
item Opens the F-wave Table
window.
ND:
Normative data entered in Histogram:
the Set Conditions window Latency of a waveform is
- Nerve page. shown as a bar

Saving Data on Disk 7

MEB-9400 Operator’s manual.
Printing a Report
When Microsoft Excel is installed in the system, the NCS measurement results
and waveforms can be printed as a report. For the report settings, refer to
“Printing a Report” in Section 8 of the MEB-9400 operator’s manual.
Full report: Measurement results and waveforms on the NCS examination

program window are printed as a report
Summary report: Measurement results on the NCS examination window are
printed as a report
1. Select the Report function button with the mouse.
2. Select the Full Report or Summary Report function button.
Report Example
7-14

Section 8 Troubleshooting
Waveform Acquisition........................................................................................................................................... 8.3

Acquiring Clear Waveforms.................................................................................................................................. 8.4
AC Interference.......................................................................................................................................... 8.4
Spike Noise................................................................................................................................................ 8.5
Other Noise................................................................................................................................................ 8.6

8. TROUBLESHOOTING
When an error message is displayed on the screen or trouble occurs, take quick
action referring to the troubleshooting table. If there is any damage or the system
is suspected to be faulty, turn the power off, attach an “Unusable” or “Repair
request” label to the system and contact your Nihon Kohden (NK) representative.

8. TROUBLESHOOTING
Waveform Acquisition
Problem Possible Cause Action

The waveform is flat or JB-942BK, JB-944BK: Press the Input ON/OFF key. The Input ON/
the amplitude is small. The Input ON/OFF key on the electrode OFF lamp lights.
junction box is not pressed.
The input sensitivity is low. Select the correct sensitivity.
The measurement electrode and grounding Remove unnecessary paste around the
electrode are shorted by paste. measurement electrode and grounding
electrode.
The waveform cannot be The input sensitivity is high. Reduce the input sensitivity.
returned to the baseline.
The waveforms cannot The amplitude of the waveform is large. Select the low sensitivity.
be averaged by the Large artifact such as stimulation signal is Remove the artifact.
rejection function. superimposed on the waveform. Change the Reject Level setting or set it to
Off. Refer to “Reject Level” (Set Conditions
window → Acquisition page).
Change the number of waveforms for average.
Refer to “Preset Count” (Set Conditions
window → Acquisition page).
The “Incorrect junction The connected electrode junction boxes cannot Use the JB-942BK or JB-944BK electrode
box is currently be used with this system. junction boxes with this system.
connected. Input select
is set to OFF” message
appears.

8. TROUBLESHOOTING
Acquiring Clear Waveforms
AC Interference
50 Hz AC interference
Category Possible Cause Action

Grounding Incomplete grounding of surrounding ME Securely ground all the ME devices connected
devices. to the patient with the equipotential grounding
method.
Electrode attachment An electrode lead makes loop and causes Bundle the electrode leads to reduce
electromagnetic induction. electromagnetic induction.
The skin-electrode contact impedance is high. Clean the electrode placement site of skin with
a cotton pad moistened with alcohol and rub
the site with Skinpure.
An electrode is not securely attached to the Securely attach the electrode with tape.
patient.
An electrode lead is faulty. Replace the electrode lead.
Other The patient is in contact with other metal. Keep the patient away from the metal.
NOTE
• When the interference is small, click the AC Interference button on the
Tool bar to check whether it is caused by AC interference.
• When using electric stimulation, set “AC Filter” to “Off” because the AC
filter distorts acquired waveforms.
• The default filter frequency is 60 Hz. When using the system in a region
with 50 Hz AC power, set it to 50 Hz.

8. TROUBLESHOOTING
Spike Noise
Noise from a fluorescent lamp

Fluorescent lamp Fluorescent lamps are nearby. Keep away from the fluorescent lamps or turn
them off.
CRT Radiated noise from a CRT. Reorient the CRT. Keep the CRT away from
the patient and tie the electrode lead wires
together.
High-power consumption An X-ray system is nearby. X-ray systems use Use a different room for measurement.
system high power which can cause interference.

8. TROUBLESHOOTING
Other Noise
EMG interference

Bio-electrical signal EMG interference, especially neck and chin Have the patient relax. Secure the head and
interference EMG during evoked potential measurement have the patient close his/her eyes and slightly
(The patient is not relaxed, is uncomfortable, open mouth.
or wants to go to the lavatory.) Adjust the pillow position or replace the
pillow.
ECG interference Increase the input sensitivity.
Increase the number of waveforms for average.
Turn the patient’s neck slowly to find a
position where the ECG waveform disappears.
Stimulation artifacts The stimulation electrode is not attached to the Check the position and the moisture or amount
patient correctly. of the paste of the grounding electrode strap.
(Be sure to place the grounding electrode
between the stimulation and measurement
sites.)
The skin-stimulation electrode contact Clean the electrode placement site of the skin
impedance is high. with a cotton pad moistened with alcohol and
rub the site with Skinpure.
The stimulation electrode cable/cord and Arrange the cable position so that the
measurement electrode lead run parallel. stimulation electrode cable/cord and
measurement electrode lead do not run parallel.
The shield of the measurement electrode lead Replace the measurement electrode.
is broken.
When Fast Recovery (Set Conditions window → Amp page) is set to on, this can immediately
recover the baseline which is affected by stimulation artifact. However, when the input
sensitivity is high, the waveform 1 ms after stimulation may be distorted.
Baseline drift Low cut (Set Condition window→ Amp page) Correct Low cut.
is too low.
Loose electrode lead (ventilation of air Fasten the electrode lead near the electrode
conditioner, respiration) with tape. (Sufficiently separate the stimulation
cord and measurement lead from each other.)
Sweat, especially frontal and occipital region Have the patient relax.
Adjust the air conditioner.
Electrostatic induction Keep the patient and system away from the
device which causes electrostatic induction.

8. TROUBLESHOOTING
Problem Possible Cause Action

The waveform around The AC interference filter is turned on. Click the AC Interference button on the Tool
50 or 60 Hz is distorted. bar, or set AC Filter (Set Condition window ��
→�
Amp page) to Off.
The waveform around 1 Fast Recovery is set to on. Set Fast Recovery to off.
ms after stimulation is
distorted.
ESU artifact An ESU is used. Locate the system as far as possible from
the ESU. When the ESU is not used,
disconnect the power cord of the ESU during
measurement. (In some cases, turning the
power off may not be enough.)
High frequency noise Electromagnetic noise from the system (e.g., Locate the system as far as possible from the
from surrounding main unit, PC unit, printer or isolation unit). patient, electrode lead, electrode junction box
devices and extension cable.
Noise due to an electrical device such as a If possible, disconnect the power cord of the
motor-operated bed, electric blanket, heater, device during measurement. (In some cases,
patient monitor, infusion pump, electrical turning the power off may not be enough.)
surgery unit, heart-lung machine Securely ground all the devices with the
equipotential grounding method.
Locate the devices as far as possible from the
patient, electrode lead, electrode junction box
and extension cable.
Noise due to a metal bed Ground the bed.
The power cord, plug socket and wall-surface Keep the patient and input system away from
wiring are close to the patient and input the power system.
system.
Other The shielding effect of the shielded room is Check the equipotential grounding of the
not enough. system and shield room.
When the cause of the artifact is not found, change the stimulation rate in 0.1 Hz steps and
average the waveforms. This is useful to average out the artifact which appears periodically and
leave only evoked waveforms.
8

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Examination Guide

If you have any comments or suggestions

Section 1 General.................................................................................... 1.1 3-4

Disinfection and Sterilization.................................................................................. 2.5

Examination Guide MEB-9400 C.1

Handling after Use................................................................................................ 2.19

Section 3 Somatosensory Evoked Potential..................................... 3.0.1

Section 3-2 Measurement – SEP/SSEP/ECSP....................................................... 3.2.1

Section 3-3 Measurement – ECG SSEP................................................................. 3.3.1

C.2 Examination Guide MEB-9400

Checking Skin-Electrode Contact Impedance............................................................... 3.3.5 1

Measurement Table Window Type I Description............................................................ 3.4.8

Examination Guide MEB-9400 C.3

Settings for Each Examination Program.............................................................. 4.1.8

Section 4-2 Measurement – ABR............................................................................ 4.2.1

Section 4-3 Measurement – MLR/SVR................................................................... 4.3.1

Section 4-4 Measurement – EcochG...................................................................... 4.4.1

C.4 Examination Guide MEB-9400

Measurement Procedure..................................................................................... 4.4.7 1

Section 4-5 Calculation........................................................................................... 4.5.1

To Open the Measurement Table Window........................................................... 4.5.9

Examination Guide MEB-9400 C.5

Section 5 Visual Evoked Potential...................................................... 5.0.1

Section 5-2 Measurement – Pattern VEP/Goggle VEP/Flash VEP........................ 5.2.1

Section 5-3 Measurement – ERG............................................................................ 5.3.1

C.6 Examination Guide MEB-9400

Stimulator SLS-3100................................................................................. 5.3.3 1

Deleting Waveforms............................................................................................. 5.3.7

Section 5-4 Measurement – EOG............................................................................ 5.4.1 3-4

Moving a Mark..................................................................................................... 5.5.7

Examination Guide MEB-9400 C.7

Evoked Measurement Table Window................................................................. 5.5.12

Section 6 EMG...................................................................................... 6.0.1

Section 6-2 Measurement – EMG........................................................................... 6.2.1

Section 6-3 Calculation........................................................................................... 6.3.1

C.8 Examination Guide MEB-9400

Deleting All Marks..................................................................................... 6.3.7 7

Making an EMG Findings Summary Table Window........................................... 6.3.14

Operation Flow............................................................................................................... 7.1.2

Section 7-2 Measurement – MCS............................................................................ 7.2.1

Examination Guide MEB-9400 C.9

Section 7-3 Calculation – MCS............................................................................... 7.3.1

Section 7-4 Measurement – SCS............................................................................ 7.4.1

C.10 Examination Guide MEB-9400

Printing Data...................................................................................................... 7.4.10 7

Section 7-5 Calculation – SCS................................................................................ 7.5.1 7-1

Section 7-6 Measurement – Rep.Stim.................................................................... 7.6.1

Examination Guide MEB-9400 C.11

Deleting Waveforms............................................................................................. 7.6.8

Section 7-7 Calculation – Rep.Stim........................................................................ 7.7.1

Section 7-8 Measurement – F-wave....................................................................... 7.8.1

C.12 Examination Guide MEB-9400

Deleting Waveforms............................................................................................. 7.8.7 7

Section 7-9 Calculation – F-wave........................................................................... 7.9.1 7-2

Measurement Table Window Type I Description.......................................................... 7.9.11

Section 7-10 Measurement – H-reflex.................................................................... 7.10.1

Examination Guide MEB-9400 C.13

Measurement Procedure................................................................................... 7.10.6

Section 7-11 Calculation – H-reflex........................................................................ 7.11.1

Section 7-12 Measurement – Blink......................................................................... 7.12.1

C.14 Examination Guide MEB-9400

Section 7-13 Calculation – Blink............................................................................. 7.13.1 7

Marking After Acquisition................................................................................... 7.13.3

Examination Guide MEB-9400

Examination Guide MEB-9400