Nerve Injuries
Nerves are the electrical wiring
system that carry messages from the brain to the rest of the body. A nerve
is like an electrical cable wrapped in insulation. A ring of tissue forms a
cover to protect the nerve, just like the insulation surrounding an
electrical cable. Motor nerves carry messages from the brain to muscles to
make the body move. Sensory nerves carry messages to the brain from
different parts of the body to signal pain, pressure, and temperature.
Nerves are fragile and can be damaged by
pressure, stretching, or cutting. Injury to a nerve can stop signals to and
from the brain causing muscles not to work properly, and one may lose
feeling in the injured area. When a nerve is cut, both the nerve and the
insulation are broken. Pressure or stretching injuries can cause the fibers
carrying the information to break and stop the nerve from working, without
damaging the cover.
A physician can often
diagnose a nerve injury by taking a detailed
history or conducting a careful physical
examination. Some nerve injuries can be objectively
verified by an EMG (electromyogram), NCV (nerve
conduction velocity test), and nerve blocks.
For an EMG, a needle
electrode is inserted through the skin into the
muscle. The presence, size and shape of the waveform provide information about the ability of the
muscle to respond when the nerves are stimulated.
An EMG can help demonstrate motor nerve
involvement.
An NCV tests the
speed of conduction of impulses through a nerve.
The nerve is stimulated with surface electrodes.
The resulting electrical activity is recorded by
other electrodes. The distance between electrodes
and the time it takes for electrical impulses to
travel between electrodes are used to calculate the
nerve conduction velocity. An NCV is helpful in
demonstrating sensory nerve damage.
A nerve block is
another tool in diagnosing nerve damage. An
anesthetic is injected onto or near the nerve. The
response a patient has to the nerve block can help
identify the specific nerves that are causing pain.
A nerve block with steroids can also be used as a
treatment for certain types of nerve pain.
Generally, the goal in fixing a nerve is to
save the cover so that new fibers may heal and work again. If there is a
space between the ends of the nerve, the doctor may need to take a piece of
nerve (nerve graft) from another part of the body to fix the injured nerve.
This may cause permanent loss of feeling in the area where the nerve graft
was taken.
Once the nerve cover is fixed, the nerve
generally begins to heal three or four weeks after the injury. Nerves
usually grow one inch every month depending on one’s age and other
factors. This means that with an injury to a nerve in the arm above the
fingertips, it may take up to a year before feeling returns to the
fingertips.
Injuries to the spinal cord are often
permanent and can cause paraplegia and quadriplegia.
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