Norm of Nerve Biopsy
Usage of Nerve Biopsy
Primarily used to aid diagnosis of infiltrative neuropathies (amyloid infiltration, hypertrophic polyneuropathy, peripheral neuropathy) and vasculitis. Also used in the diagnosis of amyloid infiltration, demyelination, inflammation axonal degeneration, lepromatous leprosy lesions, metachromatic leukodystrophy, and sarcoidosis when other testing is inconclusive.
Description of Nerve Biopsy
Removal of peripheral nerve tissue for electromicroscopic, biochemical, histochemical, or virologic examination to establish a diagnosis for neuropathies when radiologic evaluation and direct inspection have been inconclusive. Findings must be used in conjunction with clinical history and assessment findings for the most accurate diagnosis.
Professional Considerations of Nerve Biopsy
Consent form IS required.
Anticoagulant therapy, bleeding disorders, thrombocytopenia.
- Prepare for local anesthesia and obtain biopsy instruments and a 3- × 5-inch index card.
- Consult laboratory personnel for special handling of the specimen if electron microscopic examination is required.
- Just before beginning the procedure, take a “time out” to verify the correct client, procedure, and site.
- Place a 1.5-cm portion of nerve on cardboard with the firmness of a 3- × 5-inch index card and then straighten and slightly stretch it.
- Allow the specimen to adhere to the cardboard for 1 minute.
- Keep the handling of specimens to a minimum.
- Submerge the specimen in 0.05 mol/L phosphate-buffered glutaraldehyde.
- Transport specimens to the laboratory immediately.
Client and Family Teaching
- Monitor for drainage and inflammation for 24–48 hours.
- A mild analgesic may be required for pain control.
- Call the physician for signs of infection at the procedure site: increasing pain, redness, swelling, purulent drainage, or for temperature >101 degrees F (38.3 degrees C).
Factors That Affect Results
- Drying out of samples invalidates the results.
- The nerve where the biopsy specimen was taken will not regenerate.
- The most common nerve used for biopsy is the superficial peroneal sensory nerve.