Monograph: Traumatic injury to peripheral nerves-Article

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This article provides a comprehensive overview of traumatic peripheral nerve injuries, including their epidemiology, classification, prognosis, and mechanisms of recovery. The author emphasizes the importance of electrodiagnostic (EDx) assessments in the treatment and prognosis of these injuries. EDx evaluations, such as motor and sensory nerve conduction studies and needle electromyography, play a critical role in localizing nerve injuries, quantifying axon loss, and informing treatment decisions and prognostication. The article discusses the timing of EDx studies and the changes that can be observed in nerve conduction velocities, compound muscle action potentials, F waves, sensory nerve action potentials, and needle electromyography recordings based on the degree of nerve injury. <br /><br />The article further highlights the various mechanisms of recovery in peripheral nerve injuries, including recovery from conduction block, muscle fiber hypertrophy, distal axonal sprouting, and axon regrowth. The author emphasizes that motor recovery typically reaches a plateau at 18 to 24 months post-injury and that early surgical intervention is recommended for patients with complete or severe nerve injuries, as outcomes are best when nerve transfers are performed within the first 3 to 6 months after onset.<br /><br />The article concludes by discussing the role of electrodiagnostic evaluation in predicting prognosis and guiding surgical intervention. It emphasizes the importance of timely referral for surgical treatment and highlights the advancements in nerve transfer surgeries as an effective treatment option for peripheral nerve injuries. Overall, the article provides a comprehensive understanding of traumatic peripheral nerve injuries and the role of electrodiagnostic assessment in their management.

Keywords

traumatic peripheral nerve injuries

electrodiagnostic assessments

nerve conduction studies

needle electromyography

axon loss

treatment decisions

motor recovery

surgical intervention

nerve transfers

prognosis

ncs