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Sural nerve biopsy in peripheral neuropathies: 30-year experience from a single center

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Abstract

Introduction

Nerve biopsy has been widely used to investigate patients with peripheral neuropathy, and in many centers, it is still a useful diagnostic tool in this setting. In this study, we reviewed the histopathological spectrum of the nerve biopsies performed in our center in a 30-year period and we analyzed their relevance in the clinical setting.

Materials and methods

Retrospective analysis of the retrieved data was done for cases of nerve biopsies performed in our institute between 1988 and 2018. Surgical technique and histopathological analysis were done accordingly to standard protocol.

Results

Complete clinical and pathological data were available only for 717 cases. The procedure was generally safe, with only 0.3% superimposed infection. Main pathological results were “unspecific” axonal polyneuropathy (49.8%), vasculitis neuropathy (9.3%), acquired demyelinating neuropathy (8.9%), and Charcot-Marie-Tooth (8.2%). Considering clinical-neurophysiological suspicion of vasculitis, nerve biopsy confirmed the diagnosis in 60.9% of cases.

Discussion

In conclusion, for inherited neuropathies, we do not recommend this invasive procedure, but we strongly suggest a genetic test. Conversely, in vasculitic neuropathies or in dysimmune neuropathies not clearly confirmed by neurophysiological examination, nerve biopsy continues to represent a useful and irreplaceable tool.

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Acknowledgments

We thank the patients for their participation in this study.

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Author notes

  1. Marco Luigetti and Andrea Di Paolantonio contributed equally to this work.

Authors and Affiliations

  1. UOC Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A Gemelli 8, 00168, Rome, Italy

    Marco Luigetti & Paolo Maria Rossini

  2. Università Cattolica del Sacro Cuore, Rome, Italy

    Marco Luigetti, Andrea Di Paolantonio, Angela Romano, Francesco Barbato, Francesca Madia, Paolo Maria Rossini, Liverana Lauretti & Mario Sabatelli

  3. Centro Clinico NEMO adulti – Roma, Rome, Italy

    Giulia Bisogni, Amelia Conte & Mario Sabatelli

  4. UOC Neurologia, Ospedale Sant’Eugenio, Roma, Italy

    Alessandra Del Grande

  5. UOC Neurofisiopatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Francesca Madia

  6. UOC Neurochirurgia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Liverana Lauretti

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  1. Marco Luigetti
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  2. Andrea Di Paolantonio
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Correspondence to Marco Luigetti.

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Luigetti, M., Di Paolantonio, A., Bisogni, G. et al. Sural nerve biopsy in peripheral neuropathies: 30-year experience from a single center. Neurol Sci 41, 341–346 (2020). https://doi.org/10.1007/s10072-019-04082-0

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