What is axonotmesis?

A nerve is a collection of fibers, similar in structure to a cable, that is responsible for providing a pathway for electrochemical impulses to travel throughout the body. axonotmesis is a term used to describe a severe nerve injury commonly seen in peripheral nerves, resulting in disruption of the nerve's axon and myelin sheath, but leaving the supporting structures of the cells intact. The peripheral nervous system, or PNS, is the auxiliary nerves that do not include the brain or spinal cord. The axon of a nerve is the thin projections derived from the nerve cell body that carry signals away from the nerve. The myelin sheath is the electrically charged covering of the axon.

The axonotmesis does not usually affect the connective tissue framework of the nerve, including the epineurium and perineurium. The epineurium It is the toughest outer protective layer of a nerve that contains the blood vessels. The perineurium It is the middle layer of connective tissue.

Axonotmesis nerve injury is usually affected by severe contusion, also known as a hematoma or crush injury. However, it can also occur with a stretch injury. Symptoms can range from pain to dysfunction, including paralysis. Paralysis can occur to motor, sensory, or autonomic systems. Motor paralysis presents as the inability to move muscles or muscle groups. Paralysis of the sensory system disrupts the transport of electrochemical signals from the nerves. Paralysis of the autonomic system impedes the regulatory functions of the nerves, which helps the body's abilities to adapt to changes in the environment.

Nerves have the ability to regenerate or repair themselves as long as the damage is not excessive and the main portion of the nerve remains intact. Depending on the severity of the nerve injury known as axonotmesis, nerve regeneration may or may not occur. Nerve repair can take several months as regeneration is a slow process. In some cases, electrical stimulation can speed up the regeneration process.

Initially, a treatment protocol for axonotmesis includes conservative measures such as pain and inflammation management through analgesics and anti-inflammatory medications; injury management such as supports, bracing or casting measures; and close observation to continually assess symptoms. Physical therapy can also be used to help relieve pain through specialized modalities such as icing and ultrasound. A comprehensive stretching and exercise regimen helps limit protective muscle spasms and maintain surrounding muscle strength and flexibility.

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