The latencies of sympathetic skin responses.

The sympathetic skin response (SSR) was measured in 35 normal healthy adults and in 40 patients with diabetic polyneuropathy. When recording from the hand or the foot, the SSR latency was the same whether stimulating at the hand or the foot. This may suggest that the conduction velocity of afferent fibers is much faster than that of efferent fibers, so that the former do not contribute to the SSR latency. The SSR amplitudes were significantly reduced in diabetic patients (p < 0.001), but their latencies were normal as long as responses could be detected. It is possible that some surviving unmyelinated fibers and/or regenerated fibers take the responsibility for normal conduction. Another possible explanation is that the postganglionic unmyelinated fibers in polyneuropathy may represent themselves as 'all or none', i.e., either the fibers conduct with normal velocity or they do not conduct at all.