Peripheral Nerve Injury - Neuropraxia: All You Must Know

What is Neuropraxia?

Neuropraxia is often called nerve neuropraxia or peripheral neuropraxia. It represents the mildest type of peripheral nerve injury (PNI) that can lead to temporary motor and sensory loss. There are, in total, five different levels of PNIs- I to V, which differ based on the severity of nerve damage. Grade 1 PNIs are called neurapraxia. 

Peripheral nerves carry electrical signals (impulses) from the brain and spinal cord to the rest of the body. In neuropraxia, the nerve remains intact, but impulses can't pass through the body's injured part. These blocked impulses results in the occurrence of symptoms like burning, stinging, and pain.

Neuropraxia can transpire in anyone and usually follows an injury, like a fall or car accident, or sports injury. These mild nerve injuries generally heal by themselves with rest and time. Wearing protective gear during sports and physical activities can help diminish neuropraxia risk.

How is Neuropraxia Caused?

Neuropraxia can occur due to many reasons; however, the two leading causes of neurapraxia are compression and ischemia (diminished blood supply to a tissue or region). 

Traumatic neuropraxia may be because of

• Bone fractures.

• Dislocation.

•  Ligaments and tendons tears or injuries.

• Car accidents

• Sports injuries 

• Falls

• Gunshot wounds

Neuropraxia can also occur after-

• Surgery (after anesthesia).

• Giving birth.

• Dental procedures

If the neurapraxia occurs outside of a medical setting, it's essential to tell the doctor the exact timing of the accident and the onset of symptoms. This will help them determine the progress of damage and the cause.

What are the Symptoms of Neuropraxia?

Neuropraxia symptoms occur near the injury site. It causes symptoms of neuropathy like-

• Burning.

• Numbness.

• Stinging.

• Weakness.

• Pain

• Touch sensitivity 

• sensation loss

• Loss of motor abilities

• Tingling

What are the different Types of Neuropraxia?

Different types of neuropraxia include:

• Axillary neuropraxia: Injury occurs to the axillary nerve, which takes impulses to the shoulder joint and arm muscles. Thus the symptoms occur in the shoulder, arm, and hand.

• Brachial plexus neuropraxia: injury occurs to the shoulder (brachial plexus) nerves, which carry impulses from the spinal cord to arms and hands. Thus the symptoms are felt in one arm.

• Radial nerve neuropraxia: Injury happens to the radial nerve, which moves signals between the back of the arm and hand. Thus the symptoms typically occur in hand, especially the thumb, middle, and index fingers, or in the back of the hand.

• Sural nerve neuropraxia: The sural nerve is damaged, which carries impulses between the brain and calf, heel, and foot. Thus the symptoms typically occur in the ankle and foot.

How can Neuropraxia be Diagnosed?

A history of injury followed by the onset of symptoms is crucial for the diagnosis. The doctor may also perform a physical examination to check for nerve damage and may also order blood tests to check

• Complete blood count (CBC).

• Kidney, Liver, and Thyroid function.

The doctor may also order imaging scans and nerve and muscle function tests to check nerve damage and the severity of the injury. These tests include-

• CT scan.

• Electromyogram.

• MRI.

• Ultrasound of peripheral nerve and muscle.

• X-ray.

What are the different Treatment Strategies employed to treat Neuropraxia?

Neuropraxia usually heals by itself. The doctor may help manage pain by recommending the following:

• Braces, casts, and splints.

• Rest, ice, compression, and elevation (RICE).

• Pain relievers

• Avoid aggravating activity.

The doctor might also recommend neuropraxia physiotherapy treatments like range-of-motion exercises. Massage and acupuncture might also be advised in some cases.

What are the Complications associated with Neuropraxia?

Most people with neuropraxia recover fully; however, some may develop complications like:

• Inflammation.

• Nerve pain of long duration, numbness, or weakness. 

• Tissue scars near the injury site.

If cases of scar tissue formation, the doctor may advise surgery, where the surgeons free the nerve from scar tissue or release nerve compression allowing the nerve to heal.

How can Neuropraxia be Prevented?

Neuropraxia can be escaped by wearing protective equipment, like helmets and elbow pads, while participating in activities that may cause injuries. Furthermore, protecting the already injured area during healing is also crucial to prevent further nerve damage. 

Outlook/ Prognosis

Neuropraxia lasts for a few days or months, depending on the extent of the injury. Most people with neuropraxia recover totally; however, some (particularly the elderly) may take a while to heal.

At this time, the individual will completely recover all sensations and functions.  

The bottom line

Neuropraxia is a mild peripheral nerve injury that usually heals independently with time and rest. It is crucial to consult the doctor about best managing pain and other symptoms.