[Nerve conduction velocity of repeater F-waves is identical to that of M-waves].

F-wave normally varies in latency and waveform from one response to the next. But the number of identical responses in a series of F-waves may be increased with neurogenic atrophy consistent with a decreased number of motoneurons capable of responding to antidromic stimulation. They are called "repeater F-waves". We herein demonstrate some repeater F-waves observed in three patients with moderate or slight diabetic polyneuropathy. In their motor nerve conduction studies on the peroneal nerve the maximum conduction velocity was 33 m/sec in patient 1, 36 m/sec in patient 2 and 48 m/sec in patient 3. A total of 6 delayed indirect potentials were repeatedly evoked after nerve trunk stimulation. They fulfilled the characteristics of F-wave. Their conduction velocities in the leg segment were 27, 26, 23 m/sec in patient 1, 34, 33 m/sec in patient 2 and 46 m/sec in patient 3. Repeater F-waves are occasionally observed in patients with amyotrophic lateral sclerosis, cervical spondylosis or entrapment neuropathies, in which the number of motoneuron is decreased. In diabetic polyneuropathy some repeater F-waves were also observed in patients not only with moderate to severe neuropathy but also with normal nerve conduction. F-waves are generated by an antidromic backfiring of motor neurons, and they occur preferentially in large motor neurons. Larger motor neurons inhibit smaller axons through the activation of Renshaw cells. In our 3 patients conduction velocities of the repeated F-waves were all identical to the main component of M-wave. These observations reconfirmed the hypothesis that relatively large motor neurons generating F-waves are preferentially activated also in repeater F-waves.