Neurographic course Of Wallerian degeneration after human peripheral nerve injury

Introduction: Neurographic data on Wallerian degeneration (WD) after motor nerve injury are available only from animal studies and human case reports of 9 patients altogether. A precise knowledge of neurographic features of WD would be highly relevant for diagnostic, prognostic, therapeutic, and forensic aspects of traumatic lesions. Methods: We prospectively studied WD in patients with a peripheral nerve injury. They underwent sequential neurographic examinations beginning no later than 3 days after the injury until a plateau of the amplitude of compound muscle action potential was reached. Results: We examined 20 injured nerves from 16 patients. Four days after injury, all nerves showed amplitude decay to some extent, whereas 85% had reached their plateau at day 8. A length dependency of WD could be demonstrated. Conclusion: In humans, WD starts no later than day 4, shows length dependency, and is completed at day 8 in most nerves