Peripheral Nerve Injuries: Understanding Etiology and Classification

Introduction

Peripheral nerve injuries (PNIs) are common in clinical practice and can lead to significant functional impairment. Understanding their etiology and classification helps in diagnosis and treatment planning.

Etiology of Peripheral Nerve Injuries

Traumatic Causes

• Blunt force trauma
• Penetrating injuries
• Compression due to fractures or dislocations

Non-Traumatic Causes

• Metabolic disorders such as diabetes mellitus
• Autoimmune diseases like Guillain-Barré syndrome
• Infections including leprosy and herpes zoster

Classification of Peripheral Nerve Injuries

Seddon’s Classification

• Neuropraxia: Temporary conduction block without axonal damage
• Axonotmesis: Axonal disruption with intact connective tissue
• Neurotmesis: Complete disruption of the nerve structure

Sunderland’s Classification

• First-degree: Similar to neuropraxia
• Second-degree: Axonal damage with intact endoneurium
• Third-degree: Disruption of endoneurium, preserving perineurium
• Fourth-degree: Extensive damage sparing epineurium
• Fifth-degree: Complete nerve transection

Diagnosis and Management

Clinical evaluation and electrophysiological studies aid diagnosis. Treatment options include conservative management, pharmacotherapy, and surgical repair.

Conclusion

Peripheral nerve injuries require timely diagnosis and appropriate intervention for optimal functional recovery.