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Nerve and Muscle Biopsy

By Michael C. Levin, MD, Saskatchewan Multiple Sclerosis Clinical Research Chair and Professor of Neurology and Anatomy-Cell Biology; Adjunct Professor of Neurology, College of Medicine, University of Saskatchewan; University of Tennessee Health Science Center

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Nerve and muscle biopsy are usually done simultaneously.

Nerve biopsy can help differentiate axonal from demyelinating polyneuropathies when other tests are inconclusive. A nerve supplying the affected area should be chosen. If polyneuropathy may be caused by vasculitis, the sample should include skin to increase the chances of finding a characteristic vascular abnormality. If the biopsy shows that nerve endings are lost, skin punch biopsy can help confirm small-fiber polyneuropathy.

Muscle biopsy can help confirm myopathies.