Neuritis Discussion
Neuritis is a difficult problem for which there may be no satisfactory
surgical solution. Recovery depends on the exact type and degree of the
underlying problem. If there is a minor irritation, there may be profound
dysfunction followed by full or near full recovery. However, if there is
any mechanical injury, recovery is entirely unpredictable. Electrical nerve
tests or surgical exploration may be indicated if nerve damage is strongly
suspected. Nerve exploration and decompression may reduce symptoms, but
even with technically perfect surgery, sensation and strength may not
recover, although improvement often occurs. Nerve recovery is slow, and
several years are usually needed before there is a final plateau in
improvement. With recovery, patients may develop progressively worsening
tenderness or unpleasant sensations referred to as reinnervation
hypersensitivity. This usually responds to therapy of sensory reeducation
and desensitization techniques, but occasionally may require additional
surgical intervention. Nerve injuries in childhood are usually followed by
some degree of growth retardation in the area supplied by the nerve.
Because of numbness, the area is subject to injury from heat, cold and
sharp or abrasive surfaces. Chances of persistent problems are greater in
older patients, those with long standing symptoms, those with a compensation
related diagnosis, or in the context of metabolic or multiple level nerve
irritation.
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