|Generate QR code
Open Access
Subscription Access
Nerve injury: the role of electroneuromyography and ultrasound in diagnostics
https://doi.org/10.30629/2658-7947-2025-30-1-51-62
Abstract
The review is devoted to the classification, recovery mechanisms, electroneuromyographic and ultrasound diagnostics of nerve injury. In particular, the article is devoted to the parameters of sensory and motor conduction, needle electromyography, ultrasound examination of the degree of nerve damage, prognosis of restoration of nerve function and tactics of treatment of nerve injury. The mechanisms of muscle function recovery in case of nerve injury may include remyelination, axonal sprouting, axon growth from the site of injury and muscle hypertrophy. Muscle strength recovery usually takes 18–24 months after nerve injury. When diagnosing a nerve injury by the neurotmesis type, the patient should be immediately referred to a surgeon for surgery and rapid muscle reinnervation.
About the Authors
A. V. Klimkin
Federal Scientific and Clinical Center of Infectious Diseases of the Federal Medical and Biological Agency
Russian Federation
Russian Federation
St. Petersburg
M. A. Irikova
Federal Scientific and Clinical Center of Infectious Diseases of the Federal Medical and Biological Agency
Russian Federation
Russian Federation
St. Petersburg
V. B. Voitenkov
Federal Scientific and Clinical Center of Infectious Diseases of the Federal Medical and Biological Agency
Russian Federation
Russian Federation
St. Petersburg
E. Yu. Skripchenko
Federal Scientific and Clinical Center of Infectious Diseases of the Federal Medical and Biological Agency
Russian Federation
Russian Federation
St. Petersburg
References
1. Odinak M.M., Zhivolupov S.A. Diseases and injuries of the peripheral nervous system (summary of clinical and experimental experience). St. Petersburg: SpetsLit, 2009. (In Russ.).
2. Jung C, Yun JH, Kim EJ, Park J, Yeom J, Kim KE. Traumatic peripheral nerve injuries in young Korean soldiers: a recent 10-year retrospective study. J Trauma Inj. 2024 Sep;37(3):192–200. doi: 10.20408/jti.2024.0001
3. Litvinenko I.V., Zhivolupov S.A., Bulatov A.R., Kuzina E.E., Rashidov N.A., Ivanov V.S. Analysis of diagnostic and tactical errors in the management of patients with traumatic neuropathies of the extremities. Vestnik Rossijskoj Voenno-medicinskoj akademii = Bulletin of the Russian Military Medical Academy. 2019;2(66):204–208. (In Russ.). doi: 10.17816/brmma25945
4. Bateman EA, Pripotnev S, Larocerie-Salgado J, Ross DC, Miller TA. Assessment, management, and rehabilitation of traumatic peripheral nerve injuries for non-surgeons. Muscle Nerve. 2024 Jun 21. doi: 10.1002/mus.28185
5. Padovano WM, Dengler J, Patterson MM, Yee A, Snyder-Warwick AK, Wood MD, Moore AM, Mackinnon SE. Incidence of Nerve Injury After Extremity Trauma in the United States. Hand (N Y). 2022 Jul;17(4):615–623. doi: 10.1177/1558944720963895
6. Howard IM, Sedarsky K, Gallagher M, Miller M, Puffer RC. Combat-related peripheral nerve injuries. Muscle Nerve. 2024 Jun 5. doi: 10.1002/mus.28168
7. Ramón y Cajal S. A quelle époque apparaissent les expansions des cellules nerveuses de la moelle épinière du poulet. Anat. Anz. 1890;5:609–613.
8. Seddon HJ. Peripheral Nerve Injuries. Glasgow Med J. 1943 Mar;139(3):61–75. PMID: 30437076; PMCID: PMC5950788.
9. Sunderland S. A classifi cation of peripheral nerve injuries producing loss of function. Brain. 1951 Dec;74(4):491–516. doi: 10.1093/brain/74.4.491
10. MacKinnon SE, Dellon AL. Classifi cation of nerve injuries as the basis for treatment. In: Mackinnon SE, Dellon AL, editors. Surgery of the peripheral nerve. New York: Thieme. 1988b. p 35–63.
11. Perruisseau-Carrier AC, Marco Y, Fleury V, Brogan DM, Forli A, Bahlouli N. Biomechanical characterization of cadaveric brachial plexus microstructure. Hand Surg Rehabil. 2024 Sep;43(4):101745. doi: 10.1016/j.hansur.2024.101745
12. Zhivolupov S.A., Rashidov N.A., Samartsev I.N., Yakovlev E.V. Modern concepts of nerve fi ber regeneration in injuries of the peripheral nervous system. Vestnik Rossijskoj Voenno-medicinskoj akademii = Bulletin of the Russian Military Medical Academy. (In Russ.) 2013;3(43):190–198.
13. Mehrotra P, Jablonski J, Toftegaard J, Zhang Y, Shahini S, Wang J, Hung CW, Ellis R, Kayal G, Rajabian N, Liu S, Roballo KCS, Udin SB, Andreadis ST, Personius KE. Skeletal muscle reprogramming enhances reinnervation after peripheral nerve injury. Nat Commun. 2024 Oct 25;15(1):9218. doi: 10.1038/s41467-024-53276-4
14. Gordon T. Peripheral Nerve Regeneration and Muscle Reinnervation. Int J Mol Sci. 2020 Nov 17;21(22):8652. doi: 10.3390/ijms21228652
15. Korotchenko E.N., Semenova Zh.B. Selective neurotization of the median nerve in young patients with complicated spinal cord injury at the level of CV-CVII. Zhurnal «Voprosy` nejroxirurgii» imeni N.N. Burdenko = Journal “Questions of Neurosurgery” named after N.N. Burdenko. 2020;84(6):59–66. (In Russ.). doi: 10.17116/neiro20208406159
16. Pejkova S, Filipce V, Peev I, Nikolovska B, Jovanoski T, Georgieva G, Srbov B. Brachial Plexus Injuries — Review of the Anatomy and the Treatment Options. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2021 Apr 23;42(1):91–103. doi: 10.2478/prilozi-2021-0008
17. Provitera V, Piscosquito G, Manganelli F, Mozzillo S, Caporaso G, Stancanelli A, Borreca I, Di Caprio G, Santoro L, Nolano M. A Model to Study Myelinated Fiber Degeneration and Regeneration in Human Skin. Ann Neurol. 2020 Mar;87(3):456–465. doi: 10.1002/ana.25662
18. McGillivray MK, Haldane C, Doherty C, Berger MJ. Evaluation of muscle strength following peripheral nerve surgery: A scoping review. PM R. 2022 Mar;14(3):383–394. doi: 10.1002/pmrj.12586
19. Zhurbin E.A., Gaivoronsky A.I., Dekan V.S., Zheleznyak I.S., Churikov L.I., Isaev D.M. Diagnostic efficiency of ultrasound examination in peripheral nerve injuries. Rossijskij nejroxirurgicheskij zhurnal im. professora A.L. Polenova = Russian Neurosurgical Journal named after Professor A.L. Polenov. 2019;11(1):23–29. (In Russ.).
20. Wijntjes J, Saris C, Doorduin J, van Alfen N, van Engelen B, Mul K. Improving Heckmatt muscle ultrasound grading scale through Rasch analysis. Neuromuscul Disord. 2024 Sep;42:14–21. doi: 10.1016/j.nmd.2024.07.001
21. DA Silva DG, Angleri V, Scarpelli MC, Bergamasco JGA, Nóbrega SR, Damas F, Chaves TS, Camargo HA, Ugrinowitsch C, Libardi CA. Application of Artifi cial Intelligence to Automate the Reconstruction of Muscle Cross-Sectional Area Obtained by Ultrasound. Med Sci Sports Exerc. 2024 Sep 1;56(9):1840–1848. doi: 10.1249/MSS.0000000000003456
22. Xie Y, Thomas L, Hug F, Johnston V, Coombes BK. Quantifying cervical and axioscapular muscle stiffness using shear wave elastography. J Electromyogr Kinesiol. 2019 Oct;48:94–102. doi: 10.1016/j.jelekin.2019.06.009
23. Zhu Y, Jin Z, Luo Y, Wang Y, Peng N, Peng J, Wang Y, Yu B, Lu C, Zhang S. Evaluation of the Crushed Sciatic Nerve and Denervated Muscle with Multimodality Ultrasound Techniques: An Animal Study. Ultrasound Med Biol. 2020 Feb;46(2):377–392. doi: 10.1016/j.ultrasmedbio.2019.10.004
24. Tsukamoto H, Granata G, Coraci D, Paolasso I, Padua L. Ultrasound and neurophysiological correlation in common fi bular nerve conduction block at fi bular head. Clin Neurophysiol. 2014 Jul;125(7):1491–5. doi: 10.1016/j.clinph.2013.11.041
25. Ferrante MA. The Assessment and Management of Peripheral Nerve Trauma. Curr Treat Options Neurol. 2018 Jun 1;20(7):25. doi: 10.1007/s11940-018-0507-4
26. Hearn SL, Pieper JR, Yang LJ, Chang KW, Kratz AL. Implications of median sensory study to the thumb and deltoid/biceps motor unit recruitment on identifying C6 root avulsion in upper neonatal brachial plexus palsy. Muscle Nerve. 2022 Jul;66(1):24– 30. doi: 10.1002/mus.27550
27. Impastato DM, Impastato KA, Dabestani P, Ko JH, Bunnell AE. Prognostic value of needle electromyography in traumatic brachial plexus injury. Muscle Nerve. 2019 Nov;60(5):595–597. doi: 10.1002/mus.26684
28. Husseman J, Mehta RP. Management of synkinesis. Facial Plast Surg. 2008 May;24(2):242–9. doi: 10.1055/s-2008-1075840
29. Coraci D, Pazzaglia C, Doneddu PE, Erra C, Paolasso I, Santilli V, Padua L. Post-traumatic neuroma due to closed nerve injury. Is recovery after peripheral nerve trauma related to ultrasonographic neuroma size? Clin Neurol Neurosurg. 2015 Dec;139:314–8. doi: 10.1016/j.clineuro.2015.10.034
30. Goubier J-N, Teboul F. Grading of nerve injuries. In: Tubbs RS, Rizk E, Shoja MM, Loukas M, Barbaro N, Spinner RJ, editors. Nerves and nerve injuries. Amsterdam: Elsevier;2015. p. 603–10.
31. Robinson LR, Binhammer P. Role of electrodiagnosis in nerve transfers for focal neuropathies and brachial plexopathies. Muscle Nerve. 2022 Feb;65(2):137–146. doi: 10.1002/mus.27376
32. Govenko F.S., Snishchuk V.P., Klimkin A.V., Maletsky E.Yu. Closed injuries of the median nerve in children: tactics, surgical options. Pediatric surgery. 2023;27(3):202–209. (In Russ.). doi: 10.55308/1560-9510-2023-27-3-202-209
Review
For citations:
Klimkin A.V., Irikova M.A., Voitenkov V.B., Skripchenko E.Yu. Nerve injury: the role of electroneuromyography and ultrasound in diagnostics. Russian neurological journal. 2025;30(1):51-62. (In Russ.) https://doi.org/10.30629/2658-7947-2025-30-1-51-62
Views:
68
Email this article 