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Updated: Nov 16, 2025

Nerve Ultrasound Protocol to Detect Dysimmune Neuropathies

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Published on: October 7, 2021

Nerve biopsy: Current indications and decision tools.

Dev Nathani^1,2, Judith Spies^1,2, Michael H Barnett^1,2

¹Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.

|February 25, 2021

Summary

This summary is machine-generated.

Nerve biopsies are costly and often inconclusive. This review examines current indications, alternative diagnostic methods like neuroimaging, and proposes an algorithm to optimize patient selection for nerve biopsy.

Keywords:

decision aid indications for biopsy nerve biopsy neuropathology vasculitic neuropathy

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Area of Science:

Neurology
Pathology
Medical Diagnostics

Background:

Nerve biopsy is an invasive procedure used for diagnosing neuropathy.
Many nerve biopsies lack definitive pathological diagnoses, incurring significant costs and morbidity.
Advances in genomics and alternative diagnostics necessitate a re-evaluation of nerve biopsy indications.

Purpose of the Study:

To review current indications for nerve biopsy.
To discuss challenges and limitations associated with nerve biopsy.
To explore alternative diagnostic modalities and propose an algorithm for nerve biopsy selection.

Main Methods:

Literature review of current diagnostic practices in neuropathy.
Analysis of the utility of nerve biopsy versus alternative methods.
Development of a clinical decision-making algorithm for nerve biopsy.

Main Results:

Nerve biopsy selection requires careful consideration of patient, nerve, and technique.
Genomics and advanced neuroimaging (MRI neurography, ultrasound) offer promising alternatives.
Concomitant muscle and skin biopsies may enhance diagnostic yield in select cases.

Conclusions:

Optimizing patient selection is crucial to improve the diagnostic yield of nerve biopsy.
Alternative diagnostic tools can potentially reduce the reliance on nerve biopsy.
A proposed algorithm aims to guide clinicians in deciding when nerve biopsy is most appropriate.