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At least 91 records · Page 5Linked to original sources
PubMed1985

A new method of electrodiagnosis during operations on the brachial plexus and peripheral nerve injuries. The value of motor nerve action potentials evoked by trans-skull motor area stimulation.

A method is described which records efferent motor nerve action potentials (MNAPs), evoked by trans-skull motor area stimulation, directly from a nerve root or peripheral nerve fibres during operation. The records of MNAPs from the root show whether function of the anterior root is intact and its continuity retained. When recorded from the proximal stump of a divided nerve at the wrist the motor funiculus can be identified, enabling funicular nerve suture to be carried out more easily.

Action Potentials↗
PubMed1995

Paradoxical clinical consequences of peripheral nerve injury: a review of anatomical, neurophysiological and psychological mechanisms.

This paper reviews some of the possible explanations and mechanisms that may be responsible for variation from expected clinical findings soon after nerve injury in certain patients, and for subjective sensations and objective sensibility which can appear to arise from within the autonomous zone of the cutaneous distribution of a divided nerve. A number of features of peripheral innervation, central nervous system physiology and sensory psychology are discussed. These include: (1) the normal extent of overlap- or cross-innervation between the territories of adjacent peripheral nerves; (2) anomalous innervation due to normal anatomical variation; (3) ectopic impulse generation and cross-excitation between neurons in the peripheral nervous system after nerve injury; (4) neurophysiological responses and mechanisms of re-innervation other than axon regeneration across the site of nerve repair; (5) cortical somatotopic reorganisation in response to nerve injury; and (6) phantom sensory phenomena including the psychology of sensory perception.

Animals↗
PubMed1998

The contribution of capsaicin-sensitive afferents to the dorsal root ganglion sprouting of sympathetic axons after peripheral nerve injury in the rat.

Transection of the sciatic nerve leads to sprouting of sympathetic efferent, noradrenergic axons and terminals around large cell bodies in the dorsal root ganglion. Here we examined whether injury to unmyelinated afferents contributes to the sprouting. Neonatal treatment with the C-fiber neurotoxin capsaicin increased sprouting after nerve injury. We conclude that injury to large, rather than small diameter fibers, triggers the sprouting of sympathetic efferents after nerve injury.

Animals↗
PubMed2002

[Protection effect of nerve implantation after peripheral nerve injury to rats].

OBJECTIVE: To investigate the protection effect of nerve implantation to the neurons after sciatic nerve injury to adult rats. METHODS: Thirty male Sprague-Dawley rats weighing 180 - 220 g (8 - 9 weeks of age) were randomly divided into four groups. Group A consisted of normal rats without operation. In group B, the sciatic nerve of rats was transected, with the proximal stump of the sciatic nerve ligated to inhibit nerve regeneration. In group C, a sciatic nerve crushed model was set up. In group D, a sciatic nerve implantation model was established. The rats were sacrificed on postoperative days 7, 14 and 28 respectively. The L(4)-L(6) segments of the spinal cord were harvested. TUNEL technique was used to detect apoptotic motor neurons. HE and Toluidine Blue staining was used for counting motor neurons. RESULTS: The apoptotic neurons detected on the 28th postoperative day were significantly fewer in the implantation group than in the other groups (P < 0.05). The number of motor neurons was significantly higher in the implantation group than in other two control groups (P < 0.05). CONCLUSIONS: Nerve implantation exerts protective effect on neurons after nerve injury.

Animals↗
PubMed1995

[Nerve sutures and nerve grafts for repairing a gap in peripheral nerve injury: an experimental study].

An experimental study was performed using the canine sciatic nerve in order to compare the efficacies of a vascularized trunk graft (VTG), a free trunk graft (FTG), a vascularized cable graft (VCG), a free cable graft (FCG) and a two stage procedure (TSP) for the repair of a peripheral nerve defect. Both a 4 cm, and a 5 cm nerve defect was repaired using each method, and also a 6 cm defect, using VCG and FCG. After 24 weeks, the intraneural blood flow (IBF) was measured in the 4 cm defect group, and the recovery of nerve regeneration and muscle reinnervation were evaluated by motor nerve conduction velocity, wet muscle weight, and histological examinations of the nerve and the muscles. VTG and VCG both demonstrated superior IBF. The IBF after TSP was less than after VTG and VCG but greater than after FTG and FCG. In the 4 cm defect group, VTG showed the most favorable recovery in both the axonal regeneration and muscle reinnervation and was followed by VCG. Although the recovery after FTG, FCG and TSP appeared to be worse than after VTG and VCG, there was no significant difference. In the 5 cm defect group, VTG showed the most favorable recovery followed by VCG and FCG. For axonal regeneration, FTG was significantly worse than VTG, VCG and FCG. TSP was worst within the 5 cm defect group for muscular reinnervation, although it showed somewhat better axonal regeneration than FTG. In the 6 cm defect group, no significant difference was found between VCG and FCG for the axonal regeneration. Clinically, TSP is used for repairing a short nerve defect just beyond the critical distance that cannot be overcome by a primary end-to-end suture. Nerve grafting, other than FTG, appeared to be the most reliable method of bridging a long nerve defect, and FCG might be the most practical method.

Animals↗
PubMed1976

Peripheral nerve injuries in children.

Recovery after peripheral nerve injuries in children is more complete than in adults and is inversely related to the age of the patient. The prognosis for the return of sensation following laceration of the median, ulnar, or digital nerve depends upon recovery of two point discrimination (in millimeters approximately equal to the child's age) at the time of nerve repair. The better results in children probably reflect the greater adaptability of the immature central nervous system to the nerve injury. Operative exploration of an open wound when there is a potential for nerve injury in an uncooperative child is the only sure way of determining the status of the nerves. Primary repair of cleanly divided nerves in tidy wounds is advocated if it can be done competently. Secondary repair is indicated for avulsion injuries, gunshot wounds, crush injuries, and human or animal bites. Delicate, atraumatic technique and accurate repair of the divided nerve are stressed. The more exacting technique of funicular repair may yield better results. Interfascicular cable grafting is a new and useful alternative to extensive mobilization in closing nerve gaps. Nonoperative treatment of nerve injuries associated with closed fractures is advocated unless there are no signs of nerve regeneration in two to three months. Obstetrical brachial plexus injuries of the upper plexus carry a better prognosis than lower plexus or total plexus injury. Early range of motion exercises to prevent contractures are stressed. Maximal recovery takes place within two years. The acute nerve compression syndrome should be considered an emergency and may require surgical decompression if it is severe and if rapid return of function does not occur following reduction of the fracture.

Adolescent↗
PubMed1988

Nonsurgical management of pain secondary to peripheral nerve injuries.

Physicians and surgeons dealing with peripheral nerve injuries have long been plagued by the chronic intractable pain which often follows these injuries. Early recognition of the associated problems and prompt intervention by a multidisciplinary team approach to the pain is essential. Although the techniques reviewed here were presented as separate choices, the treatment of the patient should employ a combined approach of good surgical repair, positive encouragement, non-addicting medications, appropriately timed nerve blocks, aggressive physical and occupational therapy, and electrical stimulation techniques as the patient's physical recovery permits. The importance of early psychological assessment and intervention in this complex phenomenon cannot be overemphasized. Together these techniques may succeed in reducing the morbidity associated with peripheral nerve injuries.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2002

Effects of peripheral nerve injury on functional spinal VR1 receptors.

VR1 receptors, present on Adelta- and C-fibres and post-synaptic sites within the spinal cord dorsal horn, is an integrator of noxious stimuli. Here, the contribution of spinal VR1 receptors to spinal nociceptive processing in nerve injured (selective spinal nerve ligated SNL) and sham anaesthetised rats was studied. Spinal capsazepine (0.5-30 microM), a competitive VR1 antagonist, reduced noxious evoked responses of spinal neurones to a greater extent in sham operated rats, compared to SNL rats. Significant differences between the effect of spinal capsazepine on the non-potentiated component of the C-fibre evoked response of SNL and sham operated rats are reported (p< 0.01, two-way ANOVA). Our data suggest there is a functional plasticity of the spinal VR1 receptor following nerve injury.

Action Potentials↗
PubMed2003

Evidence against cholera toxin B subunit as a reliable tracer for sprouting of primary afferents following peripheral nerve injury.

In order to investigate whether cholera toxin B subunit (CTb) is transported by unmyelinated primary afferents following nerve injury, we transected the sciatic nerves of six rats, and injected the transected nerves (and in three cases also the intact contralateral nerves) with CTb, 2 weeks later. The relationship between CTb and two neuropeptides, vasoactive intestinal peptide (VIP) and neuropeptide Y (NPY), was then examined in neurons in the ipsilateral L4 and L5 dorsal root ganglia, using immunofluorescence staining and confocal microscopy. We also immunostained sections of spinal cord and caudal medulla for CTb, NPY and VIP. Following nerve section, VIP immunoreactivity was increased in laminae I-II of the spinal cord while NPY immunoreactivity was increased in laminae III-IV of the spinal cord and in the gracile nucleus. On the contralateral side, CTb labelling was detected in laminae I and III-V of the dorsal horn of the L4 and L5 spinal segments, as well as in the gracile nucleus. CTb labelling was seen in the same areas on the lesioned side, but with a dramatic increase in lamina II. No VIP or NPY immunoreactivity was observed in L4 and L5 dorsal root ganglia on the side of the intact nerve, but on the lesioned side VIP was detected in many small neurons and NPY in numerous large neurons. In agreement with the report by Tong et al. [J. Comp. Neurol. 404 (1999) 143], we found that while CTb labelling in the dorsal root ganglion on the side of the intact nerve was mainly in large neurons, on the lesioned side CTb was present in dorsal root ganglion neurons of all sizes. The main finding of the present study was that almost all of the VIP- (96%) and NPY- (98%) positive neurons in the dorsal root ganglia on the lesioned side were also CTb-labelled. After nerve injury VIP is upregulated in fine afferents that terminate in laminae I and II, and most of these probably have unmyelinated axons. Since the cell bodies of these neurons were labelled with CTb that had been injected into the transected sciatic nerve, this suggests that many of these fine afferents, which do not normally transport CTb, are capable of doing so after injury.

Afferent Pathways↗