Nerve Biopsy Evaluation
Nerve biopsies are occasionally useful in the characterization of more severe hereditary motor sensory neuropathies, congenital hypomyelinating neuropathy, and neuroaxonal dystrophy.
In addition, perineural immune complex deposition seen in some autoimmune neuropathies and changes consistent with vasculitis also may be useful diagnostically. Otherwise, nerve biopsies rarely add specific information to the diagnostic evaluation of the NMD patient beyond that information obtained from nerve conduction studies and EMG.Generally, the sural nerve is utilized. Since this is a pure sensory nerve, the usefulness of this specimen is limited to those disorders giving rise to demyelinating or axonal changes in sensory fibers. Occasionally, a small portion of the motor nerve can be obtained simultaneously with an anconeus motor point biopsy, where the motor branch is excised along with the entire muscle from origin to insertion.
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