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Nerve biopsy
Biopsy - nerve
A nerve biopsy is the removal of a small piece of a nerve for examination.
How the Test is Performed
A nerve biopsy is most often done on a nerve in the ankle, forearm, or along a rib.
The health care provider applies medicine to numb the area before the procedure. The doctor makes a small surgical cut and removes a piece of the nerve. The cut is then closed and a bandage put on it. The nerve sample is sent to a lab, where it is examined under a microscope.
How to Prepare for the Test
There is no special preparation.
How the Test will Feel
When the numbing medicine (local anesthetic) is injected, you will feel a prick and a mild sting. The biopsy site may be sore for a few days after the test.
Why the Test is Performed
Nerve biopsy may be done to help diagnose:
- Axon degeneration (destruction of the axon portion of the nerve cell)
- Damage to the small nerves
-
Demyelination
(destruction of parts of the
myelin
sheath covering the nerve)
Demyelination
Central pontine myelinolysis is brain cell dysfunction. It is caused by the destruction of the layer (myelin sheath) covering nerve cells in the mid...
ImageRead Article Now Book Mark ArticleMyelin
Myelin is an insulating layer, or sheath that forms around nerves, including those in the brain and spinal cord. It is made up of protein and fatty ...
ImageRead Article Now Book Mark Article - Inflammatory nerve conditions (neuropathies)
Conditions for which the test may be done include any of the following:
-
Alcoholic neuropathy
Alcoholic neuropathy
Alcoholic neuropathy is damage to the nerves that results from excessive drinking of alcohol.
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Axillary nerve dysfunction
Axillary nerve dysfunction
Axillary nerve dysfunction is nerve damage that leads to a loss of movement or sensation in the shoulder.
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Brachial plexopathy
Brachial plexopathy
Brachial plexopathy is a form of peripheral neuropathy. It occurs when there is damage to the brachial plexus. This is an area on each side of the ...
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Charcot-Marie-Tooth disease (hereditary)
Charcot-Marie-Tooth disease (hereditary
Charcot-Marie-Tooth disease is a group of disorders passed down through families that affect the nerves outside the brain and spine. These are calle...
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Common peroneal nerve dysfunction
Common peroneal nerve dysfunction
Common peroneal nerve dysfunction is damage to the peroneal nerve leading to loss of movement or sensation in the foot and leg.
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Distal median nerve dysfunction
Distal median nerve dysfunction
Distal median nerve dysfunction is a form of peripheral neuropathy that affects the movement of or sensation in the hands. A common type of distal me...
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Mononeuritis multiplex
Mononeuritis multiplex
Multiple mononeuropathy is a nervous system disorder that involves damage to at least 2 separate nerve areas.
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Mononeuropathy
Mononeuropathy
Mononeuropathy is damage to a single nerve, which results in loss of movement, sensation, or other function of that nerve.
ImageRead Article Now Book Mark Article - Necrotizing vasculitis
-
Neurosarcoidosis
Neurosarcoidosis
Neurosarcoidosis is a complication of sarcoidosis, in which inflammation occurs in the brain, spinal cord, and other areas of the nervous system....
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Radial nerve dysfunction
Radial nerve dysfunction
Radial nerve dysfunction is a problem with the radial nerve. This is the nerve that travels from the armpit down the back of the arm to the hand. I...
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Tibial nerve dysfunction
Tibial nerve dysfunction
Tibial nerve dysfunction is a loss of movement or sensation in the foot from damage to the tibial nerve.
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Normal Results
A normal result means the nerve appears normal.
What Abnormal Results Mean
Abnormal results may be due to:
-
Amyloidosis
(sural nerve biopsy is most often used)
Amyloidosis
Primary amyloidosis is a disorder in which abnormal proteins build up in tissues and organs. Clumps of the abnormal proteins are called amyloid depo...
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-
Inflammation of the nerve
Inflammation of the nerve
Peripheral nerves carry information to and from the brain. They also carry signals to and from the spinal cord to the rest of the body. Peripheral n...
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Leprosy
Leprosy
Leprosy is an infectious disease that has been known since biblical times. This disease causes skin sores, nerve damage, and muscle weakness that ge...
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-
Metabolic neuropathies
Metabolic neuropathies
Metabolic neuropathies are nerve disorders that occur with diseases that disrupt the chemical processes in the body
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Necrotizing vasculitis
Necrotizing vasculitis
Necrotizing vasculitis is a group of disorders that involve inflammation of the blood vessel walls. The size of the affected blood vessels helps to ...
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Sarcoidosis
Sarcoidosis
Sarcoidosis is a disease in which inflammation occurs in the lymph nodes, lungs, liver, eyes, skin, or other tissues.
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Risks
-
Allergic reaction
to the local anesthetic
Allergic reaction
Allergic reactions are sensitivities to substances called allergens that come into contact with the skin, nose, eyes, respiratory tract, and gastroin...
ImageRead Article Now Book Mark Article - Discomfort after the procedure
- Infection (a slight risk any time the skin is broken)
- Permanent nerve damage (uncommon; minimized by careful site selection)
Nerve biopsy is invasive and is useful only in certain situations. Talk to your provider about your options.
References
Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 420.
Weis J, Brandner S, Lammens M, Sommer C, Vallat JM. Processing of nerve biopsies: a practical guide for neuropathologists. Clin Neuropathol . 2012;31:7-23. PMID: 22192700 www.ncbi.nlm.nih.gov/pubmed/22192700 .
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Nerve biopsy - illustration
Nerve biopsy is the removal of a small piece of nerve for examination. Through a small incision, a sample of nerve is removed and examined under a microscope. Nerve biopsy may be performed to identify nerve degeneration, identify inflammatory nerve conditions (neuropathies), or to confirm specific diagnoses.
Nerve biopsy
illustration
-
Nerve biopsy - illustration
Nerve biopsy is the removal of a small piece of nerve for examination. Through a small incision, a sample of nerve is removed and examined under a microscope. Nerve biopsy may be performed to identify nerve degeneration, identify inflammatory nerve conditions (neuropathies), or to confirm specific diagnoses.
Nerve biopsy
illustration
Review Date: 6/1/2015
Reviewed By: Daniel Kantor, MD, Kantor Neurology, Coconut Creek, FL and Immediate Past President of the Florida Society of Neurology (FSN), Gainesville, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
