Nerve Biopsy – Indications, Procedures, Results

Biopsy – nerve

A 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 put on it. The nerve sample is sent to a lab, where it is examined under a microscope.

How to Prepare for the Test

There is no special preparation.

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)
  • Inflammatory nerve conditions (neuropathies)

Conditions for which the test may be done include any of the following:

  • Alcoholic neuropathy
  • Axillary nerve dysfunction
  • Brachial plexopathy
  • Charcot-Marie-Tooth disease (hereditary)
  • Common peroneal nerve dysfunction
  • Distal median nerve dysfunction
  • Mononeuritis multiplex
  • Mononeuropathy
  • Necrotizing vasculitis
  • Neurosarcoidosis
  • Radial nerve dysfunction
  • Tibial nerve dysfunction

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)
  • Demyelination
  • Inflammation of the nerve
  • Leprosy
  • Loss of axon tissue
  • Metabolic neuropathies
  • Necrotizing vasculitis
  • Sarcoidosis

Risks

  • Allergic reaction to the local anesthetic
  • Discomfort after the procedure
  • Infection (a slight risk any time the skin is broken)
  • Permanent nerve damage (uncommon; minimized by careful site selection)

Nerve biopsy is invasive and is useful only in certain situations. Talk to your provider about your options.

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