Diagnostic Yield of Sural Nerve Biopsy: Study from a Tertiary Care Referral Centre in India

Abstract

Background: Peripheral neuropathies are a heterogenous group of disorders with varying etiologies. A systematic approach is required for patient evaluation for cost effective diagnosis. Nerve biopsy has a good diagnostic yield if done in properly selected cases. This is especially so for the asymmetrical neuropathies particularly infectious causes like leprosy vasculitis and amyloidosis. This was a prospective study of 100 consecutive patients of peripheral neuropathy who referred to us and were undiagnosed after evaluation by physicians. Only seventy three of them underwent sural nerve biopsy for a disabling neuropathyThus in carefully selected patient group nerve biopsy is a useful aid for etiological diagnosis and management of patients more so in patients with mononeuropathy multiplex group. In this prospective planned study sural nerve biopsy altered the diagnosis in 41% and overall contributed in 80% in 36 consecutive patients. Hansen's disease was the commonest cause of neuropathy in our series and being one of the commonest treatable causes of neuropathy in an endemic country like India one must have a high index of suspicion so that early can be started and long term complications prevented.