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Nerve injury classification assists in prognosis and determination of treatment strategy for nerve injuries. Classification was described by Seddon in 1943 and by Sunderland in 1951. [ 1 ] In the lowest degree of nerve injury the nerve remains intact, but signaling ability is damaged, termed neurapraxia .
The second classification of nerve injury is known as the Sunderland classification which is more complex and specific. This classification uses five different degrees of nerve injury, the first one being the least severe and the equivalent to neurapraxia and the most severe being the fifth degree and having the same classification as neurotmesis.
Nerve injury is an injury to a nerve.There is no single classification system that can describe all the many variations of nerve injuries. In 1941, Herbert Seddon introduced a classification of nerve injuries based on three main types of nerve fiber injury and whether there is continuity of the nerve. [1]
Damage to the myelin sheath of nerves is a nerve injury. It's classified as neuropraxia or a type 1 nerve injury using the Sunderland classification. [2] It can cause a local conduction block for weeks to months as the myelin sheaths regrow, assuming no reinjury which would prolong recovery. [2]
Axonotmesis mainly follows a stretch injury. These stretch injuries can either dislocate joints or fracture a limb, due to which peripheral nerves are severed. If the sharp pain from the exposed axon of the nerve is not observed, one can identify a nerve injury from abnormal sensations in their limb.
Classification of nerve damage was well-defined by Sir Herbert Seddon and Sunderland in a system that remains in use. [7] The adjacent table details the forms (neurapraxia, axonotmesis and neurotmesis) and degrees of nerve injury that occur as a result of exposure to various temperatures, with the intent to interrupt nerve traffic and relieve pain.
Nerve compression can result in various stages of nerve injury. The majority of carpal tunnel syndrome patients have a degree I nerve injury (Sunderland classification), also called neuropraxia. [17] This is characterized by a conduction block, segmental demyelination, and intact axons.
In many cases the potential for nerve recovery (full or partial) after decompression is excellent, as chronic nerve compression is associated with low-grade nerve injury (Sunderland classification I-III) rather than high-grade nerve injury (Sunderland classification IV-V). [112] Nerve decompressions for properly selected patients are associated ...