Improving results from nerve and muscle biopsy in children: technical considerations in the harvesting of specimens

The convergence of expertise in the neurological sciences, special interest in myoneuropathology, and improved surgical technique has resulted in a significantly improved yield from muscle and nerve biopsies in children with suspected neuromuscular disorders. We present a synthesis of all those factors that we have identified as contributing to optimal results, particularly site selection, sample size, a meticulous biopsy technique that avoids the introduction of artefacts, the use of the muscle biopsy clamp, prompt processing of the specimen, and participation of the neurologist in the biopsy procedure and the interpretation of the histologic sections.