Nerve biopsy

Electrophysiologic studies usually show axonal neuropathy, but in 15%, it is demyelinating (Moulignier et al. 1997). CSF is remarkable for a mild nonspecific lymphocytic pleocytosis, but with markedly raised protein up to 2 g/L (Brew 2003). Nerve biopsy shows marked angiocentric CD8 infiltrates without mural necrosis... 

The neuropathological analysis of HIV-associated neuropathies should include the different central and peripheral nervous system structures associated with sensory pathways, including spinal cord, dorsal root ganglia (DRG), peripheral nerve, and cutaneous nerve fibers (Pardo et al. 2001) (Fig. 4.1). The majority of studies have focused on the evaluation of the peripheral nerve, often from sural nerve biopsies and the DRG. Few studies have examined the pathology of sensory pathways in the... 

Dickinson PJ, LeCouteur RA, Anderson JR, O Rourke KS, Ike RW, Pearl GS, Ghatak NR, Braund KG, Edwards RH, Round JM, et al. 2002. Muscle and nerve biopsy recommendations for the biopsy procedure and assessment of skeletal muscle biopsies. Vet Clin North Am Small Anim Pract 32 63-102. 

Diagnostic indications for nerve biopsy have become less frequent with improvements in EMG and nerve conduction techniques and the advent of specific molecular and biochemical tests for many inherited and acquired neuropathies. However, nerve biopsy does remain useful for diagnosis of vasculitis and amyloidosis, and plays an important role in research. 

The syndrome of IgMk paraproteinemia and sensory ataxia is usually encountered in elderly men. Nerve biopsy in these patients shows focal abnormalities in compaction of PNS myelin lamellae, and their IgM paraprotein recognizes epitopes of myelin-associated glycoprotein (MAG) and sulfate-3-glucuronyl paragloboside [24,42]. 

A number of cases of subacute sensory motor polyneuropathy have been described among sterilizing workers exposed to ethylene oxide. Findings have included weakness with bilateral foot drop, sensory loss, loss of reflexes, and neuropathologic changes on EMG in the lower extremities. In some cases, sural nerve biopsy showed axonal degeneration. Removal from exposure resulted in resolution of symptoms in 1-7 months. The abnormalities have... 

Among the pathologies associated with RLS, several groups [38, 40] have reported neuropathies and radiculopathies. Evidence of peripheral axonal neuropathy of a mild degree was found in some putative idiopathic RLS patients through electro-physiological (EMG/NCV) and psychophysiological tests, subsequently confirmed by sural nerve biopsy [41], These data have recently been confirmed in 30 % of 22 patients by means of skin biopsy, and related to late onset associated with pain-like symptoms [42],... 

Huglies R, Atkinson P, Coates P, Hall S, Leibowitz S (1992) Sur al nerve biopsies in Guillain-Bane syndr ome Axonal degeneration and macrophage-associated demyelination and absence of cytomegalovirus genome. Muscle Nerve 15 568—575. 

Eiihaiiced B7 cosdmulatory molecule expression in inflammatory human sural nerve biopsies. J Neurol Neurosurg Psycliia-tr-y 69 362-368. 

Wiirer J, Hughes S, Cooper J, Ben Smidr A, Savage C (2002) gamma delta T cells infiltrating sensory nerve biopsies from padents widr inflammatory neuropadry. J Neurol 249 616-621. 

Lindenlaub R, Sommer C (2003) Cytokines in sural nerve biopsies from inflammatory and non-inflanimatory neuropadiies. Acta Neuropadiol (Beri) 105 593-602. 

Krendel DA, Parks HP, Anthony DC, St Clair MB, Graham DG (1989) Sural nerve biopsy in chronic inflammatory demyelinating polyradiculoneuropathy. Muscle Nerve 12 257-264. 

Schmidt B, Toyka KV, Kiefer R, Full J, Hartung HP, Pollard J (1996) Inflammatory infiltrates in sural nerve biopsies in Gnillain-Barre syndrome and chronic inflammatory demyelinating nenropathy. Mnscle Nerve 19 474-487. 

Sommer C, Koch S, Lammens M, Gabreels-Festen A, Stoll G, Toyka KV (2005) Macrophage clustering as a diagnostic marker in sural nerve biopsies of patients with CIDP. Neurology 65 1924—1929. 

Cornblath DR, Griffin DE, Welch D, Griffin JW, McArthur JC (1990) Quantitative analysis of endoneurial T-ceUs in human sural nerve biopsies. J Neuroimmunol 26 113-118. 

Hall SM, Hughes RA, Atkinson PE, McColl I, Gale A (1992) Motor nerve biopsy in severe GuiUain-Barre syndrome. Ann Neurol 31 441 444. 

Massaro ME, Rodriguez EC, Pociecha J, Arroyo HA, Sacolitti M, Taratuto AL, Fejerman N, Reisin RC (1998) Nerve biopsy in children with severe Guillain-Barre syndrome and inexcitable motor nerves. Neurology 51 394-398. 

Schroder JM, Hoheneck M, Weis J, Deist H. Ethylene oxide polyneuropathy clinical follow-up study with morphometric and electron microscopic findings in a sural nerve biopsy. J Neurol 1985 232(2) 83-90. 

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