Neurotmesis is a severe form of peripheral nerve injury where there is a complete transection of the nerve fiber, that is, the entire nerve is completely severed, avulsed, or crushed. It is the worst degree of peripheral nerve because the components of the nerve are completely disrupted.
If neurotmesis occurs in a particular nerve, it produces a complete sensory deficit to the skin and muscles innervated by the injured nerve. Spontaneous recovery of function is extremely rare without surgical intervention, and the extent of the loss can only be determined over time.
Signs and symptoms of neurotmesis might include;
- Complete loss of sensory function always seen in the gradual onset of numbness
- Prickling or tingling in the feet or hands, which can spread upward into the legs over time.
- Dysethesias; uncomfortable sensations that get serious with time, causing extreme sensitivity to touch during the initial onset.
- Pricking, jacking, and throbbing neuropathic pains that can not be controlled with common pain relief medications.
- Extreme muscle weakness can result in a lack of coordination and falling. Especially when the motor nerves are affected.
- Loss of cognitive functions if it affects spinal nerves.
Other signs range from muscles that get smaller to color change in the skin, and changes in the amount of sweat in certain areas.
Possible causes of neurotmesis include;
- High-velocity trauma.
- Bone fractures.
- Penetrating injury.
Also, causes can include less common mechanisms such as:
- Thermal accident
- Electric shock.
Mostly neurotmesis will involve any etiology that can completely divide a nerve, but the majority of the cases involve sharp lacerations.
More about Treatment
Nerves can be injured or damaged and Neurotmesis is a complete divide or destruction of the peripheral nerve. The condition can be treated and repaired, but the recovery may take some while.
Have you ever wondered why you will shout and scream immediately when you step on a hot object? How did the information (impulse or stimulus) get to your brain to trigger your response in the shortest possible time? This is the major role your nerve plays in your body.
They are a group of fibers in the body whose primary role is to provide a pathway to conduct sensory impulses throughout the body. It essentially relays information from one part of the body to another. The nerve just like the “telephone wiring” system carries messages between the brain and the rest of the body.
Just like every other organ and tissue in the body, your nerve can sustain an injury. It is generally referred to as ‘peripheral nerve injury or damage’.
The nerve is said to sustain injury when the cells (neurons) that make up its units are damaged. The damage can result from too much pressure, stretching, or a cut.
The cut or stretch injuries to the nerve can range from mild, temporary nerve injury to a more severe, permanent nerve injury. The extent of the injury depends on the nature of the stretch or cut.
According to Seddon in 1942, the severity of nerve injury can be classified as neuropraxia, axonotmesis, and neurotmesis. This brings us to our main topic, Neurotmesis.
Where can neurotmesis occur in the body?
It can occur in any part of the body, but 73.5% of cases are seen in the upper and lower extremities of the body, that is, the arms and legs.
How do you know if you have neurotmesis?
Although it's sometimes very difficult for different neurotmesis from other classes of nerve injury, the extent of the injury has been very severe and always presents more intense signs and symptoms that may not be present in other mild forms of peripheral nerve injury.
Since every nerve in the peripheral system has a specific function, symptoms also depend on the type of nerves affected.
What are the risk factors of neurotmesis?
Neurotmesis is not so common, however, certain people are at higher risk of getting this peripheral nerve damage.
- Neurotmesis affecting the upper and lower limbs are being recognized with increasing frequency in sports, such as football and rugby.
- People who have this may have had direct contact accidents.
- Also, Neurotmesis as a result of compression and/or stretching from muscle hypertrophy has been reported in weight lifters, bodybuilders, and/or volleyball players as well as individuals who perform repetitive motions in their occupations, such as computer analysts and assembly line workers.
Treating neurotmesis takes a while and the chance of being whole again is often longer. Patients do not recover on their own, they need the aid of a medical team to get rejuvenated again.
- Neuropathic drugs such as serotonin reuptake inhibitors, tricyclic antidepressants, anticonvulsants help you with the pains as a result of the nerve damage.
- Non-steroidal anti-inflammatory, opioids, and tramadol to reduce the pains.
- Static or dynamic splinting to heal the nerve, reduce the pain, protect the injury, and improve function.
- Surgery: Although the projection that it can regain the function of the affected nerve is very low, it can be an option. In the surgical process, healthy nerves are joined to unhealthy nerves to restore the function of the affected nerve.
1. What is the best vitamin for nerve damage?
B vitamins are the best vitamins used to treat nerve damages because they aid in promoting nervous system functions.
2. Are there other types of nerve damage?
Yes, there are.
Nerve damage is classified into 3:
Neuropraxia; mild nerve damage we're there is merely a physiological block interrupting nerve signal conduction between nerves, like a muscle spasm.
Axonotmesis; second-degree damage where the connective tissues around the nerve remain intact, but there has been a little harm to the nerve.
Neurotmesis; destruction of both nerves and connecting tissues.
3. What is the difference between Neurotmesis vs Axonotmesis?
Where axonotmesis is second-degree nerve damage where the surrounding tissues around the nerve remain intact, neurotmesis is the last degree of nerve damage where the nerve and its connective tissue is damaged.
4. How long does it take to recover from nerve damage?
The time to regenerate a nerve depends on the type of nerve injury you received. A slight bruise or damage not affecting connective tissue may take 6 to 12 weeks. But for neurotmesis, the nerve can take months to regenerate because when a nerve is cut, it grows at 1mm per day.
5. Is pain a sign of nerve healing?
Pain is a sign of healing in some recovery process. In regenerating nerves, pains might occur severely but temporarily to show that the body is mending.
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