Indications and Usefulness of Nerve Biopsy

Abstract

rogress in neurophysiology and neurogenetics as well as previous neuropathological findings have all improved our knowledge of the pathophysiological characteristics of peripheral nerve disorders. 1-3 Thanks to these improvements, the indications of nerve biopsy have decreased during the past decade, making this invasive procedure unnecessary in the vast majority of patients with peripheral neuropathy.

Complications following sural and peroneal nerve biopsies

“…Fascicular biopsy has been investigated as an approach to reduce complications without success 10. Some authors have advocated immobilising the leg in a plaster cast for at least 7 days following surgery to aid wound healing2 and one group has used microsurgical repair to reduce neurological problems 17. However, this latter method can only be used if no more than 1 cm of nerve is removed.…”

“…Peripheral nerve biopsy can be a useful investigation as part of the assessment of a patient with peripheral neuropathy,1 2 particularly for the investigation of peripheral nerve vasculitis and paraproteinic neuropathies 2. The peroneal nerve is the most frequently affected peripheral nerve in vasculitic neuropathy,3 4 and although a randomised controlled study has not been carried out, using combined superficial peroneal nerve and peroneus brevis muscle biopsy to investigate peripheral nerve vasculitis has a sensitivity of about 60%,4 5 compared with less than 50% with sural nerve biopsy 4 – 7.…”

Practice Parameter: Evaluation of distal symmetric polyneuropathy: Role of autonomic testing, nerve biopsy, and skin biopsy (an evidence-based review) [RETIRED]

“…Most of the articles discussed the nerve biopsy findings in specific diseases, the clinical suspicion of which had prompted the biopsy. [23][24][25][26][27][28][29][30][31][32][33][34] No article provided guidance regarding when to perform a nerve biopsy in the evaluation of DSP.…”

Morphometric analysis of the human superficial radial nerve

“…However, when there is controversy or mononeuropathy multiplex is encountered, histopathological evaluation of nerve biopsy is performed (Said 2002;England et al 2009). In addition, regarding distal symmetrical polyneuropathy, morphological study can aid in the assessment of severity and progression, especially for research purposes (Said 1999;England et al 2009).…”