Invited Review: Electrodiagnostic Assessment of Peri-Procedural Iatrogenic Peripheral Nerve Injuries and Rehabilitation-Article

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The article, "Electrodiagnostic Assessment of Peri- Procedural Iatrogenic Peripheral Nerve Injuries and Rehabilitation," is an invited open-access review published in Muscle & Nerve in 2025. It explores the causes, diagnosis, and rehabilitation of peripheral nerve injuries that occur during or after medical procedures, known as peri-procedural iatrogenic peripheral nerve injuries (PPNI). These injuries can lead to significant functional impairments and pain, impacting the affected patients' ability to work and perform daily activities.<br /><br />The pathophysiology and etiology of PPNIs are complex and influenced by various procedural and patient-specific factors. The classification of nerve injuries into categories like neurapraxia, axonotmesis, and neurotmesis is essential for guiding their management. The review emphasizes the importance of electrodiagnostic evaluation at least four weeks post-injury, supported by nerve imaging techniques like ultrasound and MRI, to enable accurate assessment and optimized rehabilitation.<br /><br />Recognizing nerves vulnerable during medical procedures can enhance preventive measures, help in early diagnosis, and improve outcomes through timely intervention. For severe nerve injuries, surgical consultation may be necessary within six months, especially if neurotmesis, or complete nerve transection, is suspected. The article underscores the role of a multidisciplinary approach, including EDX medicine specialists, physiatrists, and nerve surgeons, in managing these injuries.<br /><br />The review also touches on risk factors such as diabetes and smoking that increase susceptibility to nerve injuries, and highlights the necessity for tailored rehabilitation programs focusing on functional recovery. It advocates for patient education and holistic management to improve quality of life and overall recovery after PPNI.

Keywords

peripheral nerve injuries

peri-procedural iatrogenic

electrodiagnostic evaluation

nerve rehabilitation

nerve imaging

neurapraxia

axonotmesis

neurotmesis

multidisciplinary approach

risk factors