DISEASE OF NERVES

Types of Nerve Injury

1. Neuropraxia - Temporary conduction block with no structural damage to the nerve.
2. Axonotmesis - Intact epineurium with axonal injury.
3. Neurotmesis - Complete transection of the nerve.

Pathology of Nerve Injury

• Neuropraxia:
  • Temporary conduction block due to edema and demyelination.
  • No structural damage to the nerve.
• Axonotmesis:
  • Intact epineurium with axonal injury.
  • Loss of axonal continuity.
• Neurotmesis:
  • Complete transection of the nerve.
  • Loss of both epineurium and axonal continuity.

Clinical Features of Nerve Injury

• Neuropraxia:
  • Temporary weakness and numbness.
  • No sensory loss.
• Axonotmesis:
  • Loss of motor function.
  • Loss of sensory function.
• Neurotmesis:
  • Complete loss of motor and sensory function.

Management of Nerve Injury

• Medical Treatment:
  • Rest, ice, compression, and elevation (RICE).
  • Pain management.
  • Physical therapy.
• Nerve Suturing:
  • Direct nerve repair.
  • Grafting.

Injuries of the Brachial Plexus

• Erb's Palsy:
  • Injury to the C5-C6 roots.
  • Weakness of the arm.
• Klumpke's Palsy:
  • Injury to the C8-T1 roots.
  • Weakness of the forearm and hand.

Radial Nerve Injury

• Causes:
  • Trauma.
  • Compression.
• Clinical Features:
  • Weakness of the extensor muscles.
  • Loss of sensation on the back of the hand and fingers.
• Management:
  • Rest, ice, compression, and elevation (RICE).
  • Pain management.
  • Physical therapy.

Ulnar Nerve Injury

• Causes:
  • Trauma.
  • Compression.
• Clinical Features:
  • Weakness of the intrinsic muscles.
  • Loss of sensation on the little finger and ring finger.
• Management:
  • Rest, ice, compression, and elevation (RICE).
  • Pain management.
  • Physical therapy.

Median Nerve Injury

• Causes:
  • Trauma.
  • Compression.
• Clinical Features:
  • Weakness of the thenar muscles.
  • Loss of sensation on the thumb and index finger.
• Management:
  • Rest, ice, compression, and elevation (RICE).
  • Pain management.
  • Physical therapy.

Claw Hand

• Causes:
  • Ulnar nerve injury.
  • Median nerve injury.
• Clinical Features:
  • Flexion of the metacarpophalangeal joints.
  • Extension of the interphalangeal joints.
• Management:
  • Rest, ice, compression, and elevation (RICE).
  • Pain management.
  • Physical therapy.

Foot Drop

• Causes:
  • Peroneal nerve injury.
  • Lumbar plexus injury.
• Clinical Features:
  • Weakness of the extensor muscles.
  • Loss of sensation on the top of the foot.
• Management:
  • Rest, ice, compression, and elevation (RICE).
  • Pain management.
  • Physical therapy.

Sciatic Nerve Injury

• Causes:
  • Trauma.
  • Compression.
• Clinical Features:
  • Weakness of the muscles of the thigh and leg.
  • Loss of sensation on the back of the leg and foot.
• Management:
  • Rest, ice, compression, and elevation (RICE).
  • Pain management.
  • Physical therapy.

Carpal Tunnel Syndrome

• Causes:
  • Compression of the median nerve.
  • Fluid buildup in the wrist.
• Clinical Features:
  • Weakness of the thenar muscles.
  • Loss of sensation on the thumb and index finger.
• Management:
  • Rest, ice, compression, and elevation (RICE).
  • Pain management.
  • Physical therapy.

Examination of Lesions of Peripheral Nerves

• Inspect:
  • Look for signs of nerve injury.
• Palpate:
  • Feel for tenderness and swelling.
• Move:
  • Test for weakness and sensory loss.
• Special Tests:
  • Perform specific tests for nerve injury.

Homoeopathic Treatment for Peripheral Nerve Injuries

• Aconitum:
  • Indicated for pain and numbness.
• Arnica:
  • Indicated for swelling and bruising.
• Hypericum:
  • Indicated for nerve injury.
• Rhus Toxicodendron:
  • Indicated for stiffness and pain.