The Physiology Of Peripheral Nerve Disease

The chief role of the axon is that of impulse conduction, which depends on the electrical cable structure and voltage-dependent ion channels of the axonal membrane. Over recent decades, the development of specialized techniques such as patch clamping and site-directed mutagenesis have established the contribution of neuronal ion channel function to the processes of impulse conduction in myelinated nerves. Recently, these insights from in vitro studies have been translated into the clinical realm. In keeping with this progress, clinical axonal excitability techniques have been developed to provide information related to the activity of a variety of ion channels, energy-dependent pumps, and ion exchange processes activated during impulse conduction in peripheral axons. These noninvasive techniques have been extensively applied to the study of the biophysical properties of human peripheral nerves in vivo and have provided important insights into axonal ion channel function in health and neurological disease, particularly in relation to the pathophysiological mechanisms that underlie neuropathy.

Here’s everything you need to know about peripheral nerve injuries and how to recognize and treat acute and chronic injuries and conditions across the lifespan. In-depth discussions, organized in a streamlined format, ensure you understand the identification, pathophysiology, assessment, and procedural interventions associated with peripheral nerve injuries. Build the knowledge base you need to evaluate the most common to complex injuries, make a diagnosis, and implement a plan of care with this one-of-a-kind resource.

Providing a detailed study of the anatomy, physiology, and pathology of peripheral nerves, this reference provides a clear approach to the evaluation, characterization, and treatment of peripheral neuropathies-reviewing each major class of these disorders with authoritative discussions of clinical characteristics, electrodiagnostic features, examination findings, and treatment options and outcomes.

The introduction of the operating microscope as a surgical tool revolutionized the treatment of peripheral nerve lesions. A new era thus began in the early 1960s, which led to a substantial improvement in the management of nerve lesions. The results of nerve grafting techniques have demonstrated that, independent of the length of the defect, lesions can be successfully bridged. The free tissue transplants with microvascular anastomosis have also opened new, rewarding possibilities for peripheral nerve reconstruction procedures, facilitating the achievement not only of satisfactory anatomical but also of satisfactory fUhctional results. In order to evaluate the state of the art and reflect retrospectively on 25 years of microneurosurgical treatment of peripheral nerves, numerous outstanding scientists and clinicosurgical physicians were invited to Hanover in order to exchange their viewpoints and experiences. An active und fruitful discussion resulted which dealt with the many aspects of anatomy, pathology, clinical and neuro physiology, diagnosis, and with the surgery and physiotherapy which constitute modern-day peripheral nerve lesion treatment. The excit ing ongoing experimental and clinical activities have led us to support the wish and idea to publish the scientific exchange which took place during the Hanover symposium. I truly believe that the articles presented in this book cover so many interesting subjects concerned with peripheral nerve lesions that the book will serve the interested and dedicated physician involved with such cases as a reference work for the basics and also provide him with the therapeutic guidelines to assist him in his daily work.

Disorders of the peripheral nervous system (PNS) are the cause of prominent neurological symptoms including weakness, sensory loss, pain and autonomic dysfunction associated with deficits, morbidity and mortality. These disorders may be primary hereditary or cryptogenic neurologic disorders confined to the PNS or part of the pathology of both the central nervous system and the PNS. Most PNS disorders are secondary to other system disorders and may be responsive to treatment of the primary disease. Important advances have been obtained in several areas including molecular genetics, biochemistry, immunology, morphology and physiology that have enhanced our understanding of the causes and consequences of damage to peripheral nerve. Understanding of both these groups of PNS diseases has greatly expanded over recent years and has led to important advances of treatment both to protect and to repair damages of peripheral nerve. This volume provides an overview of the state-of-the-art of examination, diagnosis and treatment of these very diverse disorders and will be of interest to both the research and clinical neuroscience and neurology communities. Covers both hereditary and cryptogenic neurologic disorders Includes advances in the basic science of PNS from molecular genetics, biochemistry, immunology, morphology and physiology Detailed coverage of neuropathy in connective tissue disorders, infectious disorders, metabolic disorders and malignancy

The peripheral nervous system is usually defined as the cranial nerves, spinal nerves, and peripheral ganglia which lie outside the brain and spinal cord. To describe the structure and function of this system in one book may have been possible last century. Today, only a judicious selection is possible. It may be fairly claimed that the title of this book is not misleading, for in keeping the text within bounds only accounts of olfaction, vision, audition, and vestibular function have been omitted, and as popularly understood these topics fall into the category of special senses. This book contains a comprehensive treatment of the structure and function of peripheral nerves (including axoplasmic flow and trophic func tions); junctional regions in the autonomic and somatic divisions of the peripheral nervous system; receptors in skin, tongue, and deeper tissues; and the integrative role of ganglia. It is thus a handbook of the peripheral nervous system as it is usually understood for teaching purposes. The convenience of having this material inside one set of covers is already proven, for my colleagues were borrowing parts of the text even while the book was in manuscript. It is my belief that lecturers will find here the information they need, while graduate students will be able to get a sound yet easily read account of results of research in their area. JOHN 1. HUBBARD vii Contents SECTION I-PERIPHERAL NERVE Chapter 1 Peripheral Nerve Structure 3 Henry deF. Webster 3 1. Introduction .