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What Happens If You Cut A Nerve

by Lyndon Langley
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What Happens If You Cut A Nerve

What Happens If You Cut A Nerve

What happens if you cut a nerve?
A nerve usually has two parts — an outer covering called the epineurium (or perineurium), which protects the nerve fibers; and an inner structure called the endoneurium, made up of the individual nerve fibers themselves. The endoneurium contains bundles of myelin sheaths filled with fat around each fiber. When injury occurs to this protective layer or to the nerves themselves, it’s possible for damage to occur to the axon itself as well. This type of injury results in inflammation and scar tissue formation, which may result in permanent degeneration.
The most common cause of peripheral neuropathy (nerve damage) is diabetes mellitus. It affects about 2 million Americans and causes more than 90 percent of cases of severe peripheral neuropathy. In addition, there are other types of neuropathies caused by conditions such as alcoholism, HIV/AIDS, cancer, autoimmune diseases and vasculitis. Some people also develop neuropathies because of medications they take. Drugs used to treat high blood pressure, antidepressants, anticonvulsants and some antibiotics may be linked to tardive neuropathy.
Injury to any part of the nervous system can lead to neuropathy. Peripheral neuropathies, those affecting only the extremities (hands, feet, legs and arms), account for 80 to 85 percent of all neuropathies [Source: National Organization on Disability]. There are three main categories of peripheral neuropathy: acute, chronic and traumatic. Acute neuropathies include Guillain-Barré syndrome, toxic neuropathy, leprosy, Lyme disease, progressive multifocal leukoencephalopathy (PML), sarcoidosis, systemic lupus erythematosus (SLE) and Whipple’s disease. Chronic neuropathies include fibromyalgia, diabetic neuropathy, Charcot-Marie-Tooth disease and Parkinson’s disease. Traumatic neuropathies include carpal tunnel syndrome, stroke and spinal cord injuries.
Cutting a nerve sounds scary but it isn’t uncommon. About one in 100 operations performed on an adult involves cutting a nerve, either during surgery or when treating an injury to another body part. Most patients recover without complications, but like anything else, there are risks associated with having your nerves handled by someone who doesn’t have much experience. Cutting a nerve requires precision and skill, so it should be done under the care of an experienced surgeon. Surgeons use different methods depending on what kind of nerve needs to be removed or repaired.
If you’re considering surgery for a specific condition or ailment, your doctor will likely ask how long you’ve had pain or problems related to your particular problem. He or she will want to know if treatment options have been tried before he or she considers taking out your nerve. Surgery is not always necessary for every type of nerve disorder. For instance, if you have carpal tunnel syndrome, your doctor might recommend avoiding surgery since other treatments, including wrist splints and steroid injections, work just as well. Similarly, if you suffer from back pain, sciatica or pinched nerves, your primary physician will probably recommend noninvasive therapies such as physical therapy, massage or acupuncture instead of surgery.
Surgery for a damaged nerve often entails removing the affected portion of the nerve and surrounding tissues and stitching the ends together again. During surgery, doctors make small cuts through muscle and connective tissue to expose the injured nerve. They then remove the dead tissue and foreign matter and suture the nerve ends back together using fine surgical thread. Afterward, they put a dressing over the wound and give the patient anti-inflammatory medication and antibiotics. Patients are advised to keep their hands elevated while sleeping and avoid strenuous activity until after the healing process is complete.
Nerves supply the organs and limbs with information from the central nervous system. They carry impulses from sensory receptors (such as touch, heat, cold and pain). These electrical impulses travel along the length of the nerve where specialized cells called neurons receive them and pass them along toward the central nervous system. From there, motor neurons send messages down the length of the nerve to the areas required for movement. Sensory neurons relay messages back to the central nervous system. Nerves are enclosed within layers of soft tissue called connective tissue, which allow them to move easily yet protect them from external forces. One of these layers is known as the dura mater, which surrounds the brain and spinal cord.
The word “neuron” comes from the Greek word neuron meaning “nerve.” Neurons contain cell bodies, branching processes called dendrites, and long extensions called axons that transmit electrical impulses across synapses. Axons branch into smaller branches called collateral branches to form networks between neurons. Within the axon are mitochondria, granules containing neurotransmitters and synaptic vesicles. Neurotransmitters are chemicals released at the synapse from one neuron onto another, triggering changes in the receiving neuron.
The most important neurotransmitter is acetylcholine, which transmits messages from the cerebral cortex to muscles. Another important transmitter is dopamine, which acts on the reward centers of the brain. Glutamate is involved in memory function and learning. Serotonin helps regulate sleep cycles and moods. GABA regulates neural circuits involved in sleep, appetite and anxiety. Endorphins act as natural painkillers.
The human body has 206 pairs of cranial nerves. All except eight originate in the brain stem. Cranial nerves 1 through 12 are responsible for controlling voluntary movements of eye, eyelids, mouth, tongue, face, jaw, nose, lips, ears, throat, vocal cords and salivary glands. Nerves 13 through 19 control involuntary actions such as blinking, swallowing, coughing and sneezing. Cranial nerve 20 controls the diaphragm, heart and abdominal functions. Nerve 21 communicates with the ear, facial muscles, scalp and neck muscles. Nerve 22 influences breathing, sweating, lacrimation and pupillary reflexes. Nerve 23 relays messages from the ear, skin, joints and internal organs. Nerve 24 regulates reproductive systems and sexual arousal. Nerve 25 is connected to the ovaries, uterus, fallopian tubes and breasts. Finally, nerve 26 provides innervation for the kidneys, adrenals and pancreas.
Cranial nerve palsy refers to a temporary or permanent inability to control voluntary movements due to damage to a single root or bundle of roots. Symptoms depend upon whether the affected nerve supplies motor or sensory functions. Motor symptoms include paralysis, weakness, spasticity, slowness of movement, difficulty chewing, speaking, swallowing, drooling and smiling. Sensory symptoms can include numbness, blindness, deafness, double vision, paralysis, hypoacusis (hearing impairment), paresthesia (numbness or sharp pains) and dysdiadokinesia (uncoordinated hand movements).
Symptoms of compression of a nerve are similar to those of a lesion. Compression may be caused by tumors, bone fractures, infection, arteriovenous fistulas, cysts, inflammation, vascular malformations, congenital deformities, multiple sclerosis, trauma and others.
Some forms of neuropathy affect more than one nerve. Polyradiculoneuropathy affects many roots simultaneously, whereas mononeuropathy affects a single root or trunk. Mononeuropathy can be divided into focal mononeuropathy, which stems from a localized lesion or compression, and segmental mononeuropathy, which develops when a single nerve root becomes inflamed or demyelinated.
Mononeuropathies that affect the brachial plexus (roots C5 to T1) are collectively known as Erb’s palsy. Lesions of this nature typically occur following obstetric emergencies such as shoulder dystocia. Other examples of brachial plexus lesions include avulsion of the subclavian artery and vein, traction injury to the brachial plexus, dislocation of the cervical spine, fracture of the first rib, rhabdomyolysis (an extreme breakdown of skeletal muscle fibers), cerebrospinal fluid leakage, pneumatization of the lung, rupture of the thyroid gland, and birth defects such as Poland Syndrome. Brachial plexus injuries can also occur as a result of general anesthesia, with the most frequent being phrenic nerve palsy. Phrenic nerve palsy occurs when the diaphragm loses its tone during anesthesia. The patient begins breathing air from his or her chest instead of lungs. Phrenic nerve palsy must be immediately corrected via artificial respiration.
As discussed earlier, peripheral neuropathies are categorized according to the severity of symptoms. As the level of disability increases, so does the complexity of diagnosis and treatment. Damage to the radial nerve (carpal tunnel syndrome) is considered mild compared to damage to the median nerve (Erb’s palsy).
This article is intended to provide basic understanding of the anatomy of nerves, as well as some of the most common disorders involving them. If you think you may have a neurological disorder, consult your health care provider.

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