Classification of Nerve Injuries

By Carolyn Kisner PT, MS and Lynn Allen Colby PT, MS on February 6th 2009

Nerve injuries are classified using either the Seddon or Sunderland classification systems; both are based on structural and functional changes that occur in the nerve with various degrees of damage. These systems describe the degree of injury to nerve substructures and the effect on prognosis. Seddon’s system describes three levels of pathology: neuropraxia, axonotmesis, and neurotmesis. Sunderland’s classification details five levels of injury and potential for recovery.

Seddon’s Classification and Characteristics of Nerve Injury

Neuropraxia
• Segmental demyelination
• Action potential slowed or blocked at point of demyelination; normal above and below point of compression
• Muscle does not atrophy; temporary sensory symptoms
• Cause: mild ischemia from nerve compression or traction
• Recovery is usually complete

Axonotmesis
• Loss of axonal continuity but connective tissue coverings remain intact
• Wallerian degeneration distal to lesion
• Muscle fiber atrophy and sensory loss
• Cause: prolonged compression or stretch causing infarction and necrosis
• Recovery is incompletesurgical intervention may be required

Neurotmesis
• Complete severance of nerve fiber with disruption of connective tissue coverings
• Wallerian degeneration distal to lesion
• Muscle fiber atrophy and sensory loss
• Cause: gunshot or stab wounds, avulsion, rupture
• No recovery without surgeryrecovery depends on surgical intervention and correct regrowth of individual nerve fibers in endoneural tubes.

Buy the Book that holds this excerpt: Therapeutic Exercise: Foundations and Techniques (Therapeutic Exercise: Foundations & Techniques)

Related Articles

Recovery of Nerve Injuries

Filed Under: Jeff, Physical Therapy
Tags: Axonotmesis, Injuries, Neurotmesis

No Comment Received

Leave A Reply

« Impaired Nerve Function

Management of Vascular Disorders of the Extremities »

Tag Cloud

abdomen abdominal abdominals abdominis acetabulum acromioclavicular activities Acute adhesions Administration Aerobic Aerobic Exercise aerobics agonist ambulation aids anatomical anesthesia annulus fibrosus anterior/posterior shear anterior pillar anterolateral antigravity aponeurosis arthritic arthritis Arthrokinematics arthroplasty arthroscopy Assisted atrophy back pain Balance Benefits biomechanical body mechanics Breathing Cancer capsulitis capsulotomy cardiopulmonary Cardiovascular Causes cemented cementless cervical Cervical Spine Characteristics chest chondromalacia patella Chronic chronic fatigue circuit weight training Clinical closed-chain concentric concentric contractions conditioning contracture contraindications contralateral coracohumeral Core Muscle curves DCER Decision deformity degeneration degradation delayed-onset muscle soreness dermatome Diagnosis disability Disablement Model disease disuse duration dynamic dynamic exercise dynamic exercises dysfunction eccentric efficiency environment equilibrium Equipment Ethical etiology Euthanasia Evaluation Examination exercise exercises Expiration extremity facet joints facilatation Fatigue Femur Fetal Response fibrocartilage fibrocartilagenous lip fitness Flexibility flexion flexor foramina fossa frequency frontal plane motion Full-Arc Exercise Function functional functional limitation functional limitations glenohumeral glenoid glenoid fossa gluteus medius Gratf Guidelines Guillain-Barre syndrome Health-care hemiarthroplasty hemiarthroplasy hip history hybrid arthroplasty hydraulic hyperextension hypermobility iliac crest iliofemoral iliolumbar iliotibial ilium immobilization impairment impairments inflammation infraspinatus Injuries injury Inspiration intensity Intervention intervertebral Intra-abdominal intradiskal pressure ischiofemoral ischium isokenitic isokenitic regimen isokinetic Isokinetic exercise isometric joint mobilization kinesiologic kinesthetic Labor lateral shear leg limb-girdle longus colli lordosis Lower lower extremity lumbar lumbar spine lumborum lumbosacral Management Manual Resistance Exercise Maternal Maternal Response mechanical resistance mechanoreceptors Medical clearance Medications meniscoid Methods microtrauma Mobility Mobilization Model Modified motor movement Multifidus multiprofessional approach Muscle muscle contraction Muscle endurance Muscle performance muscles Muscle strength Muscoloskeletal musculoskeletal myotomes neck nerve Neural Neurogenic neurological Neuromuscular neuropathy non-weight-bearing Occupational Therapy osteoligamentous osteonecrosis Osteoporosis osteotomy Overload Principle pain palliative palpation Passive patella femoral joint pathological fracture pathologies pathology Patient patients Pelvis percentages performance periarthritis Phases physical fitness Physical Therapist Physical Therapy physician physiological plyometric training pneumatic PNF posterior posteriorly posterior pillar posterolatera postimmobilization Postoperative Postpartum Postpolio syndrome postsurgica postsurgical Postural Posture power PRE Precautions Pregnancy Preoperative Prevention Preventive Principles Procedure Process Prognosis progressive resistance exercise protocols psychological pulleys Pulmonary pulposus radiculopathy radiographic evidence Rationale re-examination recovery Rehabilitation Rehablitation Relaxation repetitions resistance Resistance Exercise resistance training Respiration Respiratory rest rheumatoid arthritis ROM safety sagittal plane motion SAID principle scapular posture scapulothoracic Short-Arc Shoulder shoulder girdle sling spinae spinal column Spine spondylolisthesis spondylolysis spondylosis stability stabilization Stage 1 stenosis sternoclavicular Sternoclavicular Joint stiffness strength stress stretch Stretching structure subacromial submaximal subscapularis suprascapular nerves supraspinatus surgery Surgical symptoms synovial fluid synovial joints systems review technique techniques temporomandibular joint test Testing testing procedures Therapeutic Exercise therapist therapy thoracolumbar Thoracolumbar fascia Thorax TOS training transverse plane motion transversus abdominis trapezius trauma treatment triaxial joint Trimester tuberosity Types Upper Uses Valsalva Valsalva maneuver Varicose Veins Velocity Ventilation volume weight-bearing weights Withholding