Seddon classification of nerve injuries
Sir Herbert Seddon in 1942 described a scheme for describing nerve injuries according to the extent of damage to axons and surrounding connective tissue layers. It has clinical relevance in that it indicates the likely prognosis:
- neuropraxia:
- no anatomical disruption
- a localised, physiological and transient conduction block along a nerve
- usually a result of a blunt injury
- no distal Wallerian degeneration occurs
- very variable, but often a motor paralysis with some residual sensory or autonomic function
- nerve conduction studies show a conduction block at the level of the injury
- typically, there is recovery in days to weeks
- a diagnosis of exclusion
- axonotmesis:
- axonal damage within the nerve
- axonal degernation but endoneurial tubes and surrounding connective tissue elements remain intact
- distal Wallerian degeneration
- often the result of a more intensive blunt injury
- full recovery is usual but may take weeks to months; there may be a residual deficit
- neurotmesis:
- nerve divided
- usually violent, open injuries
- all axons and connective tissue elements disrupted
- Wallerian degeneration distally
- some recovery possible but much more likely with surgical nerve repair
- full recovery unlikely
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