nervskador

Nervskador, or nerve injuries, are injuries to peripheral nerves that affect motor, sensory, and sometimes autonomic function. They can result from trauma (blunt or penetrating injuries, crush injuries), compression or entrapment, stretching, or iatrogenic causes such as surgical procedures. They are commonly classified by severity using schemes such as Seddon and Sunderland. Seddon describes neurapraxia (a temporary conduction block with preserved axons), axonotmesis (axonal damage with intact supportive tissue), and neurotmesis (complete nerve disruption). Sunderland expands this into five grades, with increasing disruption of axons and surrounding structures, often influencing prognosis and treatment decisions.

Symptoms depend on which nerve is affected and may include numbness, tingling, weakness, muscle atrophy, reduced reflexes, and autonomic changes such as altered sweating or skin temperature. Some injuries heal spontaneously, particularly neurapraxia, within days to weeks; others involve axonal damage (axonotmesis) with slower recovery, and complete nerve disruption (neurotmesis) may require surgery.

Diagnosis combines clinical examination with electrodiagnostic tests—nerve conduction studies and electromyography—to assess axonal integrity and muscle innervation. Imaging methods such as ultrasound or magnetic resonance imaging can identify entrapment, compression, or structural lesions contributing to the injury.

Treatment focuses on protection and symptom control, followed by rehabilitation. Mild injuries may be managed conservatively with splinting and physical therapy. More severe injuries or those with no early signs of recovery may require surgical intervention, including microsurgical nerve repair, autologous nerve grafts, nerve transfers, or nerve conduits, sometimes in combination with tendon transfers. Prognosis varies and depends on injury severity, location, timing of treatment, and patient factors; distal injuries generally have better recovery potential than proximal ones.