Peripheral Nerve Stenosis, Injuries and Tumors- Neurosurgery

What are peripheral nerves?

Peripheral nerves are the links between brain and spinal cord and the rest of the body. They are fragile and can be easily damaged.

Peripheral nerve injuries:

The brain’s ability to communicate with organs and muscles of the body gets affected if the nerve is injured. The nerves may be damaged due to health conditions such as diabetes or Guillain-Barre syndrome or due to stretching or pressing on the nerves.

Nerves are made of fibers which are called axons. Axons are surrounded by tissues that act like insulation. In case of mild peripheral nerve injuries either the fibers or the insulation are damaged. Mild injuries are more likely to heal. During mild injury, the patient may have symptoms such as numbness or tingling or weakness in shoulder, arm, hand, or leg.

On the other hand, in severe peripheral nerve injuries both the fibers and the insulation are damaged, and the nerve might be entirely cut. These severe injuries are very difficult to treat. Patient with severe injuries would have total loss of feeling to the damaged area.

Pain medicines (aspirin or ibuprofen) or corticosteroid injections are prescribed depending on the severity of nerve injury. Surgery is performed in case of severely damaged nerves.

Neurologists, Neurosurgeons and Orthopedic doctors are the medical specialists involved in treating peripheral nerve injuries.

Peripheral nerve Tumours:

Peripheral nerve tumours are growths in or near the peripheral nerves and can occur anywhere in the body.  Some tumours may be due to inherited syndromes, such as neurofibromatosis (types 1 and 2) and schwannomatosis. A malfunctioning gene or injury or surgery may also cause peripheral nerve tumours. Symptoms of this condition include pain, numbness or tingling, dizziness, swelling or a lump under skin, weakness etc. Treatment generally involves surgery to remove the tumour. Other treatments may be recommended id it is difficult to remove the tumour without affecting nearby healthy nerves and tissues. An Oncologist and Oncosurgeon will propose the treatment plan for peripheral nerve tumours.

Spinal stenosis:

Spinal stenosis generally occurs in the lower back and the neck. Spinal stenosis is basically a narrowing of the spaces within spine that puts pressure on the nerves. Symptoms of spiral stenosis include Weakness in a hand, arm, foot or leg, numbness or tingling in a hand, arm, foot or leg trouble while walking and maintaining balance, neck pain, bowel or bladder dysfunction (only in severe cases), and back pain. This condition can be diagnosed by a CT or MRI scan. Treatment options include surgery, physical therapy, pain medications, and anti-seizure drugs. Orthopedic surgeons specialized in spine surgeries will generally perform the surgery for spinal stenosis.

References:

• https://www.mayoclinic.org/diseases-conditions/peripheral-nerve-tumors/symptoms-causes/syc-20355070
• https://www.mayoclinic.org/diseases-conditions/spinal-stenosis/symptoms-causes/syc-20352961
• https://www.mayoclinic.org/diseases-conditions/spinal-stenosis/diagnosis-treatment/drc-20352966
• https://medlineplus.gov/peripheralnervedisorders.html
• https://www.mayoclinic.org/diseases-conditions/peripheral-nerve-injuries/symptoms-causes/syc-20355631

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