Personal injury
claims for peripheral nerve injuries can run the gamut between mild radiating
pain that goes away with some treatment to debilitating conditions that last a
lifetime. In the U.S., as many as 20 million people suffer from damage to
their peripheral nerves. Two of the most common causes of peripheral nerve
injuries are car accidents and falls, but they can happen with other types of
accidents and activities as well, including carpal tunnel syndrome from
repetitive hand motions, industrial accidents and penetrating traumas. People
who have suffered from peripheral nerve damage may face permanent problems,
depending on the severity of their injuries. When the injuries happen in
accidents that were caused by others, an experienced Los Angeles personal
injury attorney may be able to help injured plaintiffs to recover damages to
pay for their losses.
Causes
Motor vehicle
accidents account for 46 percent of the cases of peripheral nerve injuries.
Motorcycle crashes account for 10 percent of the cases. Pedestrian accidents
and gunshots round out the top four causes. The most frequently damaged nerve
is the radial nerve that runs down through the arm. It is commonly damaged when
a person’s humerus bone is fractured. People may suffer from brachial plexus
injuries in motor vehicle crashes. The brachial plexus is a bundle of nerves
that originate from the spinal cord in order to innervate the arms, hands and
fingers. In many cases, people who have peripheral nerve injuries also have
other injuries to their central nervous systems. An estimated 60 percent of
people who suffer from peripheral nerve injuries also suffer from traumatic
brain injuries.
Symptoms
The symptoms
that people suffer when they have peripheral nerve injuries will vary,
depending on the location of the injury and its severity as well as which type
of nerve is damaged. The peripheral nerves send signals to the brain from
different areas of the body. The person’s symptoms will depend on whether he or
she suffered damage to the motor, sensory or autonomic nerves as well as the
degree of injury to the nerves. Motor nerves are responsible for muscle movements,
and people who have damage to them may then experience muscle weakness.
Autonomic nerves control the body’s automatic processes that are involved with
breathing, temperature regulation, glandular and heart functions and digestive
processes. Sensory nerves communicate information about pain and the feeling of
light touches.
The degree of
neuronal damage is classified as one of five levels. The prognosis for recovery
depends on the severity of the level.
First-degree
peripheral nerve injuries
First-degree
peripheral nerve injuries are the most minor injury types. Injuries in this
category are characterized by nerve damage that is caused by an interruption of
blood flow to the nerve or by damage to the myelin sheath that surrounds it.
People who have first-degree peripheral nerve injuries have excellent prognoses
and are normally fully recovered within a few weeks to a few months.
Second-degree
peripheral nerve injuries
With these
injuries, the coverings of the nerve are intact, but the nerve fibers themselves
are damaged. Most people can expect good recovery outcomes that depend on how
far away the injury site is from the muscle.
Third-degree
peripheral nerve injuries
In third-degree
injuries to the peripheral nerves, the neural axons are disrupted as well as
some of the nerve coverings. People who suffer from third-degree injuries
generally have poor recoveries because their nerves tend to grow in the wrong
directions.
Fourth-degree
peripheral nerve injuries
Fourth-degree
injuries involve axonal disruptions along with more disruptions to the nerve
coverings. Unless people have surgery, they will have poor recoveries.
Fifth-degree
peripheral nerve injuries
Fifth-degree
injuries to the peripheral nerves occur when all of the nerve and its covering
is damaged. People will have poor recoveries, and surgery may or may not work.
A common type
of peripheral nerve injury in an accident is an injury to the brachial plexus.
This injury may occur in accidents that cause a vehicle occupant’s head and
neck to stretch too far. Some people may also have tears to the nerves.
Depending on the severity of the injury, some people may suffer permanent
disabilities in the affected arm. People who have more minor brachial plexus
injuries may experience muscular weakness in the hand and arm from which they
may recover over a few weeks.
Treatments
The treatment
of peripheral nerve injuries will depend on their severity. For more severe
injuries, surgical repair may be indicated. A surgery can be performed either
shortly afterward or later. When a sharp nerve laceration has occurred,
immediate surgery will be used. If a nerve needs to be grafted, it will happen
several weeks after the accident.
Nerve
reconstruction is performed around three to four weeks after the accident. By
this time, the nerve endings will have formed small bundles that will have to
be cut out and a graft put in place to connect the ends. Surgeons may wait for
several months in order to see if any innervation of the muscles has occurred.
Delayed nerve reconstructions are normally used to repair very proximal
lesions.
Surgeons may
also perform tendon transfers. This will require some muscle retraining after
the graft is completed. The outcomes following surgery will depend on which
nerve is injured and what technique is used to repair it. Some people will be
able to recover full function while others will never recover.
Rehabilitation
Many people who
have suffered peripheral nerve injuries will also need to undergo
rehabilitation. The rehabilitation will focus on improving muscle function
while preventing further disability. Passive range-of-motion exercises will
likely need to be performed every day in order to prevent nerve contractions.
Using the limb
early is important to help to prevent further atrophy of the muscles. It may
also help to improve the nerve function. Some rehabilitation professionals will
use electrical stimulation in order to help to prevent atrophy.
Ultrasound may
be an alternative treatment to aid in recovery following a peripheral nerve
injury. Ultrasound radiation may help nerves to regenerate faster. Splinting is
also often performed to help prevent contractions and to help to substitute for
the loss of motor function.
Credit · Steven Sweat from natlawreview.com
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