272 - Peripheral Nerve Examination, Evaluation, and Biopsy

Abstract

In this chapter, we review the key components of the history and physical examination for patients with focal peripheral nerve disorders. We emphasize certain fundamental settings during evaluation and examination and further elaborate on key points of motor, sensory, and pathological signs, evoking maneuvers, as well as pain components. Online videos accompanying this chapter will be of high value for the reader’s understanding of main aspects of focused examination techniques for specific important nerves (see Videos 271.1 through 271.5Video 272.1Video 272.2Video 272.3Video 272.4Video 272.5). We also briefly comment on the application of supplemental imaging, electrodiagnostic studies, and intraoperative electrophysiology in confirming the diagnosis and following patients over time. We conclude with a discussion about the indications and utility of peripheral nerve biopsies, along with a summary of recent literature regarding its diagnostic value and utility. Topics covered include history and physical examination, motor- and sensory-focused nerve evaluation and examination, pathologic signs, and peripheral nerve biopsy yield.