ISSN 2398-2950      

Biopsy: nerve

ffelis
Contributor(s):

Kyle Braund

Simon Platt


Introduction

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

Uses

  • It can provide information about nerve structure.
  • It can help to confirm inflammatory, degenerative and metabolic diseases of the nerve.
  • It can provide information about the severity of the nerve disease.

Advantages

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

Disadvantages

  • It requires anaesthesia 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.
  • It is best performed after electromyographical analysis of the neuromuscular system.
  • It requires special shipping procedures to be arranged on an overnight basis to a specialised laboratory if the full complement of investigative techniques are to be run.
  • It may miss patchy and localised diseases and so more than one sample is advised; it may not be representative of what is occurring at a more proximal or distal level on the 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 the clinician in addition to the choice of nerve, there may be a subsequent nerve morbidity to consider.
  • It may not accurately reflect the function of the 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 Pract​ 32 (1), 63-102 PubMed.
  • Braund K G (1991) Nerve and Muscle Biopsy techniques. Progress in Veterinary Neurology (1), 35-56 VetMedResource.

Organisation(s)

  • The Animal Health Trust, Centre for Small Animal Studies, Newmarket, Suffolk, England CB8 7UU

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