- See: EMG
- Nerve Injury Discussion:
- remember that in any case of presumed nerve injury, always consider whether an isolated compartment syndrome had occured;
- neuropraxia:
- least severe injury, is characterized by a conduction block (focal conduction block);
- conduction across the zone of nerve injury is inhibited, however, conduction within the nerve both proximal and distal to the lesion remains intact;
- continuity of all structures is preserved;
- Wallerian degeneration does not occur (no axonal loss) but there is focal demyelination;
- complete recovery is evident in 3 to 6 weeks;
- after a simple crush injury function may return within days;
- w/ neuropraxia there is immediate conduction block across the site of injury with normal conduction distally;
- with severe trauma, there is focal demyelination w/o disruption of axons, and slowing of the conduction velocity can be demonstrated across the lesion;
- conduction block is restored once myelin regeneration is restored (taking weeks to months);
- axonotmesis:
- is more severe injury, with disruption of axons & surrounding endoneurial sheaths;
- perineurium and epineurimum remain intact;
- Wallerian degeneration occurs;
- after axonotmesis, conduction velocity may be preserved distally for up to 7 days;
- recovery is good but may require many months;
- neurotmesis:
- Wallerian degeneration occurs;
- Complications:
- reflex sympathetic dystrophy
- neuroma
Erythropoietin Accelerates Functional Recovery After Peripheral Nerve Injury
Pain relief after nerve resection for post traumatic neuralgia.
Treatment of the painful neuroma by neuroma resection and muscle implantation.