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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]
Seddon's classification of nerve injuries came to be adopted internationally. [9] He used the terms neurapraxia, axonotmesis and neurotmesis which had been coined by Lord Cohen of Birkenhead. [7] These were based on the severity of the nerve injury, which in turn influenced the anticipated time for recovery and the prognosis. [7]
Seddon's classification, devised in 1943, continues to be used, and is based on three main types of nerve fiber injury, and whether there is continuity of the nerve. [29] Neurapraxia: The mildest form of nerve injury. It involves an interruption of the nerve conduction without loss of continuity of the axon.
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.
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.