Superficial Peroneal Nerve/Peroneus Brevis Muscle Biopsy in Vasculitic Neuropathy

Abstract

The diagnosis of vasculitic neuropathy, which causes severe disability, is critical, since the timely diagnosis provides basis for treatment and clear benefit to the patient. Nerve biopsy is the standard method of diagnosing vasculitic neuropathy. In this study, afl patients undergoing superficial peroneal nerve/peroneus brevis muscle biopsy (SPN/PBM) for possible vasculitis in Laboratory of Neuromuscular Diseases of Hacettepe University Neurology Department from 1995 through June 1999 were analysed. Biopsies were classified as positive, negative or suspicious for vasculitis. Of 32 SPN/PBM biopsies, 9 showed definite vasculitis; nerve was diagnostic in 7 and muscle in 5. Three of the 9 patients who were classified as suspicious for vasculitis, diagnosed as definite with clinical and laboratory features. The most detected suspicious finding was asymmetrical fiber loss. None of the patients with biopsies classified as negative, developed definite vasculitis on their follow-up. These findings established the sensitivity of SPN/PBM in diagnosing vasculitic neuropathy. SPN/PBM biopsy seemed to be prior to sural nerve biopsy, since biopsy materials from both muscle and nerve tissues could be held with one incision and the sensitivity of biopsies increase with increasing the number of analysed nerve and muscle blocks.