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Aberrant conduction in human peripheral nerve

Ephaptic transmission?

Neurology Section, Veterans Administration Medical Center, Salem, VA.

Late motor responses were recorded from the foot muscles of patients with neuropathy after stimulation of the posterior tibial nerve at the ankle. The latencies were too short to involve the spinal cord, but latencies were reduced by more proximal stimulation, indicating that the pathway begins with proximal conduction. The response differed from previously reported "axon reflexes," because it appeared on supramaximal stimulation. It was attributed to reflection of an impulse at a discontinuity of the myelin sheath. In 2 of 32 subjects, stimulation of the medial plantar nerve in the great toe resulted in reproducible motor responses with latencies of 37 and 38 msec in the flexor hallucis brevis. Ephaptic transmission was implied.

Address correspondence and reprint requests to Dr. Tomasulo, Neurology Section, Veterans Administration Medical Center, Salem, VA 24153.

Presented in part at the thirty-second annual meeting of the American Academy of Neurology, New Orleans, LA, May 1980.

Accepted for publication November 23, 1981.

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