Abstract
This chapter discusses the histological diagnosis of denervation. The histochemical study of muscle biopsies has provided new morphological criteria of denervation. Both group atrophy and type grouping are reliable index of denervation but much less specific and sensitive than an increased terminal innervation ratio (TIR). These muscle fiber changes are found in a limited number of biopsies from denervating conditions, particularly the type grouping pattern, and they are occasionally observed in myopathy, whereas the TIR is increased in the majority of biopsies from denervation, even in clinically normal muscles, and remains normal in practically all cases of myopathy. Other changes, namely small angulated dark fibers and impaired fiber type differentiation, are misleading because they are found both in denervation and myopathy and cannot be taken as evidence of denervation if other data suggesting this possibility are not available. The small fibers of both types may become angulated in all kinds of muscular atrophy, provided there is neither loss of muscle fibers nor endomysial proliferation.
Published Version
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