Nerve biopsy
Biopsy - nerveA 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 is put on it. The nerve sample is sent to a lab, where it is examined under a microscope.
How to Prepare for the Test
Follow your provider's instructions on how to prepare for the procedure.
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)
Myelin
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)
Nerve biopsy is usually done to look for inflammation that could be damaging the nerve. Conditions for which the test may be done include any of the following:
- Mononeuritis multiplex (disorder that involves damage to at least two separate nerve areas)
Mononeuritis multiplex
Multiple mononeuropathy is a nervous system disorder that involves damage to at least two separate nerve areas. Neuropathy means a disorder of the n...
ImageRead Article Now Book Mark Article - Necrotizing vasculitis (group of disorders that involve inflammation of the blood vessel walls)
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 ...
ImageRead Article Now Book Mark Article - Neurosarcoidosis (complication of sarcoidosis, in which inflammation occurs in the brain, spinal cord, and other areas of the nervous system)
Neurosarcoidosis
Neurosarcoidosis is a complication of sarcoidosis, in which inflammation occurs in the brain, spinal cord, and other areas of the nervous system....
ImageRead Article Now Book Mark Article - Abnormal protein deposits on the nerve (amyloid)
- Vasculitis of the nerve
- Suspected tumor of the nerve
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 rare disorder in which abnormal proteins build up in tissues and organs. Clumps of the abnormal proteins are called amyloid...
ImageRead Article Now Book Mark Article - Demyelination
- 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...
ImageRead Article Now Book Mark Article - Leprosy
Leprosy
Leprosy is a disease caused by the bacterium Mycobacterium leprae. This disease causes skin sores, nerve damage, and muscle weakness that gets worse...
Read Article Now Book Mark Article - Loss of axon tissue
- Metabolic neuropathies (nerve disorders that occur with diseases that disrupt the chemical processes in the body)
Metabolic neuropathies
Metabolic neuropathies are nerve disorders that occur with diseases that disrupt the chemical processes in the body
ImageRead Article Now Book Mark Article - Necrotizing vasculitis
- Sarcoidosis
Sarcoidosis
Sarcoidosis is a disease in which inflammation occurs in the lymph nodes, lungs, liver, eyes, skin, and/or other tissues.
ImageRead Article Now Book Mark Article
Risks
Risks of the procedure may include:
- 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). A small patch of skin may be permanently numb afterwards.
Nerve biopsy is invasive and is useful only in certain situations. Talk to your provider about your options.
References
Chernecky CC, Berger BJ. Nerve biopsy - diagnostic. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:814-815.
Midha R, Elmadhoun TMI. Peripheral nerve examination, evaluation, and biopsy. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 245.
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: 5/4/2021
Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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