Nerve biopsy

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Nerve biopsy
ICD-9-CM 04.11-04.12
MedlinePlus 003928

In medicine, a nerve biopsy is an invasive procedure in which a piece of nerve is removed from an organism and examined under a microscope. A nerve biopsy can lead to the discovery of various necrotizing vasculitis, amyloidosis, sarcoidosis, leprosy, metabolic neuropathies, inflammation of the nerve, loss of axon tissue, and demyelination.

Contents

Biopsy literally means an examination of tissue removed from a living body to discover the presence, cause, or extent of a disease.

A nerve biopsy may be necessary when a patient experiences numbness, pain, or weakness in places such as the fingers or toes. A nerve biopsy can help to determine the cause of such symptoms.[ medical citation needed ] The procedure is usually only performed when all other options have failed in determining the cause of a disease. [1] It is an outpatient procedure that is performed under local anesthetic. [2]

Uses

A nerve biopsy can potentially find the cause of the numbness or pain experienced in the limbs. It can reveal if these symptoms are caused by damage to the myelin sheath, damage to the small nerves, destruction of the axon in the nerve cells or neuropathies. [3]

Procedure

A sample piece of a nerve is cut from an affected area. The three different types of nerve biopsies each employ a slightly different procedure. For each procedure, the patient is given a local anesthetic to numb the area to be operated on. The patient remains conscious throughout the procedure. The surgeon makes a small incision and removes part of the nerve before closing the incision. Once the nerve has been removed, it is sent to a laboratory for examination. [3]

Types

Sensory

For this procedure, a 1-inch patch of sensory nerve is removed from the ankle or shin, during which the patient may experience temporary or permanent numbness on the top or side of the foot.[ medical citation needed ]

Selective motor nerve

A nerve sample is taken from the inner thigh when a motor nerve is affected. [3]

Fascicular

The nerve is exposed and separated, then given a small electrical impulse to help understand which nerve should be removed and examined. [3]

Risks

The most significant risk is long-term nerve damage and loss of sensation. Less significant risks include discomfort after the procedure, allergic reaction to the anesthetic, and infection. [3]

Related Research Articles

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Charcot–Marie–Tooth disease (CMT) is a hereditary motor and sensory neuropathy of the peripheral nervous system characterized by progressive loss of muscle tissue and touch sensation across various parts of the body. This disease is the most commonly inherited neurological disorder, affecting about one in 2,500 people. It is named after those who classically described it: the Frenchman Jean-Martin Charcot (1825–1893), his pupil Pierre Marie (1853–1940), and the Briton Howard Henry Tooth (1856–1925).

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<span class="mw-page-title-main">Peripheral neuropathy</span> Nervous system disease affecting nerves beyond the brain and spinal cord

Peripheral neuropathy, often shortened to neuropathy, is a general term describing damage or disease affecting the nerves. Damage to nerves may impair sensation, movement, gland, or organ function depending on which nerves are affected; in other words, neuropathy affecting motor, sensory, or autonomic nerves result in different symptoms. More than one type of nerve may be affected simultaneously. Peripheral neuropathy may be acute or chronic, and may be reversible or permanent.

<span class="mw-page-title-main">Polyneuropathy</span> Medical condition

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Neuralgia is pain in the distribution of one or more nerves, as in intercostal neuralgia, trigeminal neuralgia, and glossopharyngeal neuralgia.

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Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve, most commonly of the second and third intermetatarsal spaces, which results in the entrapment of the affected nerve. The main symptoms are pain and/or numbness, sometimes relieved by ceasing to wear footwear with tight toe boxes and high heels. The condition is named after Thomas George Morton, though it was first correctly described by a chiropodist named Durlacher.

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Ulnar nerve entrapment is a condition where the ulnar nerve becomes physically trapped or pinched, resulting in pain, numbness, or weakness, primarily affecting the little finger and ring finger of the hand. Entrapment may occur at any point from the spine at cervical vertebra C7 to the wrist; the most common point of entrapment is in the elbow. Prevention is mostly through correct posture and avoiding repetitive or constant strain. Treatment is usually conservative, including medication, activity modification, and exercise, but may sometimes include surgery. Prognosis is generally good, with mild to moderate symptoms often resolving spontaneously.

<span class="mw-page-title-main">Endometrial biopsy</span> Diagnostic medical procedure

The endometrial biopsy is a medical procedure that involves taking a tissue sample of the lining of the uterus. The tissue subsequently undergoes a histologic evaluation which aids the physician in forming a diagnosis.

<span class="mw-page-title-main">Ulnar neuropathy</span> Medical condition

Ulnar neuropathy is a disorder involving the ulnar nerve. Ulnar neuropathy may be caused by entrapment of the ulnar nerve with resultant numbness and tingling. It may also cause weakness or paralysis of the muscles supplied by the nerve.

<span class="mw-page-title-main">Skin biopsy</span>

Skin biopsy is a biopsy technique in which a skin lesion is removed to be sent to a pathologist to render a microscopic diagnosis. It is usually done under local anesthetic in a physician's office, and results are often available in 4 to 10 days. It is commonly performed by dermatologists. Skin biopsies are also done by family physicians, internists, surgeons, and other specialties. However, performed incorrectly, and without appropriate clinical information, a pathologist's interpretation of a skin biopsy can be severely limited, and therefore doctors and patients may forgo traditional biopsy techniques and instead choose Mohs surgery. There are four main types of skin biopsies: shave biopsy, punch biopsy, excisional biopsy, and incisional biopsy. The choice of the different skin biopsies is dependent on the suspected diagnosis of the skin lesion. Like most biopsies, patient consent and anesthesia are prerequisites.

Hereditary sensory and autonomic neuropathy (HSAN) or hereditary sensory neuropathy (HSN) is a condition used to describe any of the types of this disease which inhibit sensation.

<span class="mw-page-title-main">Renal biopsy</span> Removal of kidney tissue for medical examination

Renal biopsy is a medical procedure in which a small piece of kidney is removed from the body for examination, usually under a microscope. Microscopic examination of the tissue can provide information needed to diagnose, monitor or treat problems of the kidney.

<span class="mw-page-title-main">Nerve compression syndrome</span> Human disease

Nerve compression syndrome, or compression neuropathy, or nerve entrapment syndrome, is a medical condition caused by chronic, direct pressure on a peripheral nerve. It is known colloquially as a trapped nerve, though this may also refer to nerve root compression. Its symptoms include pain, tingling, numbness and muscle weakness. The symptoms affect just one particular part of the body, depending on which nerve is affected. The diagnosis is largely clinical and can be confirmed with diagnostic nerve blocks. Occasionally imaging and electrophysiology studies aid in the diagnosis. Timely diagnosis is important as untreated chronic nerve compression may cause permanent damage. A surgical nerve decompression can relieve pressure on the nerve but cannot always reverse the physiological changes that occurred before treatment. Nerve injury by a single episode of physical trauma is in one sense an acute compression neuropathy but is not usually included under this heading, as chronic compression takes a unique pathophysiological course.

Peripheral mononeuropathy is a nerve related disease where a single nerve, that is used to transport messages from the brain to the peripheral body, is diseased or damaged. Peripheral neuropathy is a general term that indicates any disorder of the peripheral nervous system. The name of the disorder itself can be broken down in order to understand this better; peripheral: in regard to peripheral neuropathy, refers to outside of the brain and spinal cord; neuro: means nerve related; -pathy; means disease. Peripheral mononeuropathy is a disorder that links to Peripheral Neuropathy, as it only effects a single peripheral nerve rather than several damaged or diseased nerves throughout the body. Healthy peripheral nerves are able to “carry messages from the brain and spinal cord to muscles, organs, and other body tissues”.

References

  1. Weis J, Brandner S, Lammens M, Sommer C, Vallat JM (2012). "Processing of nerve biopsies: a practical guide for neuropathologists". Clin Neuropathol. 31 (1): 7–23. doi:10.5414/np300468. PMC   3663462 . PMID   22192700.
  2. "Nerve Biopsies - Frequently Asked Questions".
  3. 1 2 3 4 5 "Nerve biopsy". MedlinePlus Medical Encyclopedia. 29 April 2023.