There are multitude of neuromuscular diseases that are exceptionally difficult to diagnose. In some cases, even extensive clinical examination and laboratory workups fail to reveral a diagnosis. In these cases, a nerve and or a muscle biopsy might be required to secure a diagnosis. Once a definitive diagnosis is obtained, the appropriate prognosis and treatments may be provided.
Essentially any nerve or muscle in the body can used for biopsy. The majority of biopsies sample muscles and nerves that are surgically-accessible with a local anesthetic with a minimum of effort. These procedures are almost invariably tolerated quite easily by awake patients.
Common muscles subjected to biopsy are the quadriceps, deltoid, biceps, gastrocnemius, and gracilis muscles.
Common nerves subjected to biopsy are the superficial peroneal, sural, superficial radial sensory, and gracilis.
Figure 1. Biopsy of the superficial peroneal nerve just above the ankle.
The gracilis nerve is a motor nerve that supplies the gracilis muscle in the thigh. As a motor nerve, it is an extremely useful nerve used in the diagnosis of motor neuron diseases such as amyotrophic lateral sclerosis (ALS).
If you have been told that you require a nerve and/or muscle biopsy, please contact us at (212) 342-2776 to set up an appointment to see Dr. Chrisopher Winfree. To assist our office in scheduling your visit and biopsy procedure as efficiently as possible, please bring either a prescription or note from your physician who is requesting the biopsy, specifying the location of the biopsy. There are many potential sites where these biopsies can be performed, and having this information ready at the time of your first visit with Dr. Winfree is most helpful.
Dr. Winfree will explain the details of the biopsy procedure with you. These procedures are typically performed on an outpatient basis, meaning you will likely go home the same day as the procedure. Most patients return to Dr. Winfree’s office 2 weeks after the surgery to make sure healing is going well, and to review the biopsy results. Patients are also provided with a written report describing the biopsy results, and our office also sends the report to each of the referring physicians. Patient then can arrange a follow-up appointment to see their referring physician to discuss diagnostic and treatment recommendations.
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