Neurophysiology of nerve damage.

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bma
Posts: 24
Joined: Sun Aug 25, 2013 5:26 pm

Neurophysiology of nerve damage.

Post by bma »

PS.: I am posting here an answer about neurophysiology that made ​​a user of this forum. But the response was so full that I decided to put as a topic. I apologize for the redundancy. If you want to delete the other post, moderator. (original:http://www.pudendalhope.info/forum/view ... =36&t=5758)

A nerve can suffer several injuries:
Neurapraxia, Axonotmesis, Neurotmesis (Seddon, H.J.: Classification of nerve injuries, British Medical Journal, 2:237, 1942). Neurapraxia is a light lesion with symptons of numbness.
http://brachialplexus.wustl.edu/injury.html

People who suffer Neurapraxia can improve very quickly. One must understand that bodies are different and a more optimistic approach can be applied to many cases. It's strange, but we seem to forget that the pudendal nerve is... a nerve! and it is exposed to the same type of trauma and compressions that other nerves . Its a sensory and motor nerve (as many others). The pain of the genitofemoral, ilioinguinal and hypogastric nerves is terrible, too. Generally a feeling of numbness and sexual impotence characterizes only one type of problem, the Neurapraxia, which can be reversed with the return of blood flow (ischemic injury dont have good blood flow).Theres not lose of tissue. Just light compression (such as numbness of the legs crossed, a type of transient neurapraxia).

Nerve trauma occurs from contusion, stretching, or laceration:

Other conclusion fromhttp://www.chiro.org/ACAPress/Periphera ... tries.html:

"Contusion (neurapraxia). Recovery is usually within 6 weeks. Contusion may be the result of either a single blow or through persistent compression. Fractures and blunt trauma are often associated with nerve contusion and crush. Peripheral nerve contusions exhibit early symptoms when produced by falls or blows. Late symptoms arise from pressure by callus, scars, or supports. Mild cases produce pain, tingling, and numbness, with some degree of paresthesia. Moderate cases manifest these same symptoms with some degree of motor-sensory paralysis and atrophy.

Crush (axonotmesis). Recovery rate is about an inch per month between the site of trauma and the next innervated muscle. If innervation is delayed from this schedule or if the distance is more than 6 inches, surgical exploration should be considered.

Laceration (neurotmesis). Laceration follows sharp or penetrating wounds and is less frequently seen associated with tears from a fractured bone's fragments. Surgery is usually required. A traction injury typically features several sites of laceration along the nerve. Stretching injury is usually limited to the brachial plexus."

Nerve Structure:
Image

Abdominal Nerves with can simulate Pudendal neuralgia:
Image

Sources.:
http://www.fpnotebook.com/ortho/neuro/P ... vInjry.htm
http://brachialplexus.wustl.edu/injury.html
http://www.netterimages.com/image/29567.htm
http://www.orthopaedicsone.com/display/ ... sification
http://www.chiro.org/ACAPress/Periphera ... tries.html
http://www.orthobullets.com/hand/6066/p ... and-repair
- Blocking done by Dr. Luciano Braun, Brazil
- bLock in piriformis - no response
- Physiotherapy, good response, 50%
- Therapy with low lidocaine infusion, good response .30%
- Surgery? Perhaps. But I'm incredulous.
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