Fibrillation potential onset in peripheral nerve injury

Fibrillation potentials are an accepted electrical marker of muscle denervation that occur in axonal nerve injury. Clinically, they are used to determine the type of, and prognosis for nerve injuries. The time of occurrence after nerve injury plays a critical role in clinical decision making. This study explores the evolution of the generally accepted guideline that fibrillation potentials occur 1 to 4 weeks after axonal nerve injury.

Pubmed, Ovid, and EMBASE, and current textbooks were reviewed. References were recursively followed back to the initial description of fibrillation potentials.

The majority of our understanding regarding the timing of onset of fibrillation potentials appears to arise from animal experiments in the mid-20th century.

Despite frequent use in human clinical care, published evidence for the 1 to 4 week guideline comes almost entirely from animal studies. An appreciation of this background and resulting limitations aids clinical application of this guideline.