Kim S
Arch Phys Med Rehabil. 1980 May;61(5):210-3.
Serial nerve conduction studies were done in 5 patients with Guillain-Barre syndrome, 4 of whom were recovering and 1 who did not recover. In a total of 20 paired studies, the nerve conduction velocity deteriorated in spite of improvement in distal and proximal latencies in 5 cases, and nerve conduction velocity improved in spite of deterioration of latencies in 1 case. This seeming contradiction is explained by the following hypothesis: when the conduction velocity is not homogeneous along the course of the nerve because of a segmental demyelination which takes place in a spotty pattern, both longitudinally and transversely, the fastest fiber from the proximal stimulation point may not necessarily be the fastest from the distal stimulation point. If the fastest fibers from the 2 stimulating points are not the same fibers, the conduction time between these 2 points as calculated by measuring the onset of motor response may be artificially prolonged. This will give a falsely slow conduction velocity. Using this hypothesis in segmental demyelinating disease, latency alone is a better parameter of nerve conductivity than nerve conduction velocity, and serial latencies may correlate better with the clinical course than do serial conduction velocities.
对5例格林-巴利综合征患者进行了系列神经传导研究，其中4例正在康复，1例未康复。在总共20次配对研究中，尽管5例患者的远端和近端潜伏期有所改善，但神经传导速度仍恶化；1例患者尽管潜伏期恶化，但神经传导速度却有所改善。这种看似矛盾的现象可由以下假设解释：当神经由于节段性脱髓鞘而在整个行程中传导速度不均匀时，这种节段性脱髓鞘呈散在分布，无论纵向还是横向，来自近端刺激点的最快纤维不一定是来自远端刺激点的最快纤维。如果来自两个刺激点的最快纤维不是同一根纤维，那么通过测量运动反应的起始点计算出的这两点之间的传导时间可能会被人为延长。这将导致传导速度被错误地判定为减慢。将这一假设应用于节段性脱髓鞘疾病时，单独的潜伏期比神经传导速度更能反映神经传导性，系列潜伏期可能比系列传导速度与临床病程的相关性更好。
