Peripheral Nerve Monitoring

Monitoring of peripheral nerves has also been performed in patients undergoing nerve plexus or single-nerve explorations to locate areas of injury and assess axonal continuity. Patients with prolonged weakness and sensory loss after nerve injury may undergo nerve exploration to determine whether nerve reconstruction may improve outcome. The area of the lesion is determined by preoperative nerve conduction studies. Intraoperatively, the nerve is first stimulated proximal to the lesion, and a recording of the nerve action potential is made directly from the nerve distal to the lesion. If there is nerve conduction across the lesion, lysis of scar is performed, and the incision is closed. Natural recovery by means of axonal regrowth produces the best outcome. If, however, conduction does not occur across the lesion, resection of the damaged nerve and nerve cable grafting is performed. ^{[165] [173] [174]}