Canis ISSN: 2398-2942

Biopsy: nerve

Synonym(s): Nerve biopsy

Introduction

  • A nerve biopsy can provide important information about disease processes responsible for clinical signs of peripheral nerve disease.
  • May not provide a definitive diagnosis as often as is the case with muscle biopsies, but will be able to confirm axonal loss and demyelination.
  • Nerve biopsy can take place in conjunction with muscle biopsy to provide maximal information about any underlying neuromuscular diseases, but actual biopsy is technically more demanding as is the histopathological examination.

Uses

  • Provides information about nerve structure.
  • Helps to confirm inflammatory, degenerative and metabolic diseases of nerve.
  • Provides information about severity of nerve disease.

Advantages

  • Provides specific histological and ultrastructural information about nerve structure.
  • Any nerve potentially can be biopsied.
  • Can be performed at the same time as muscle biopsy.

Disadvantages

  • Requires anesthesia which may be a financial consideration as well as a patient stability concern if there is associated neurogenic disease of the larynx raising the possibility of aspiration pneumonia Lung: aspiration pneumonia.
  • Best performed after electromyographical Electromyography analysis of neuromuscular system.
  • Requires special shipping procedures to be arranged on an overnight basis to a specialized laboratory if the full complement of investigative techniques are to be run.
  • May miss patchy and localized diseases and so more than one sample advised; may not be representative of what is occurring at a more proximal or distal level on nerve.
  • Although there may be a definitive resultant diagnosis of demyelination, the actual cause of this may not be evident from the biopsy alone.
  • Depending on the skill of clinician, in addition to choice of nerve, there may be subsequent nerve morbidity to consider.
  • May not accurately reflect function of nerve.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Excellent.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Dickinson P J & LeCouteur R A (2002) Muscle and Nerve Biopsy. Vet Clin North Am Small Anim Prac 32 (1), 63-102 PubMed.
  • Braund K G (1991) Nerve and Muscle Biopsy techniques. Progr in Vet Neurol (1), 35-56 VetMedResource.


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