Nerve and Muscle Biopsy

Purpose
Muscle and nerve biopsies are done for 2 purposes:

1. To diagnose certain abnormalities in the muscle and/or the nervous system.
2. To check the progress of an already diagnosed condition.

Preparation
Before being scheduled for a biopsy, the physician will perform a brief medical history and a physical examination which may include blood work and testing of the muscle and nerves. Please tell your doctor at this time if you have any allergies. Also tell the doctor at this time if you are on any aspirin, aspirin products, coumadin or heparin. These medications cause abnormal bleeding at times.

As an outpatient, you will be asked to fast from midnight on and until the procedure is done. Also notify your doctor if you are a diabetic.

Report to NSOC the day of your procedure at the scheduled time. The nurses will finish the necessary preparations and you will be taken to the operating room.

After the procedure the operating room personnel will bring you back to NSOC to recover and receive further instructions.

Medications used during the procedure may make you drowsy, so you must have someone present to drive you home.

Wear clothing that is comfortable and easy to put on.

If you would become ill with a fever, cold or flu prior to your procedure, please contact NSOC at 319/356-2237 or the hospital operator (319/356-1616) and page the resident on call, and very likely your procedure will be rescheduled.

Muscle
The muscle biopsy is relatively simple and takes approximately one hour to perform. The doctor makes a small (2 inch) incision over a muscle that has been selected on the basis of your symptoms. The most commonly used muscles are the biceps in the upper arm; the deltoid in the shoulder; or the quadricep in the upper thigh. The cosmetic effect may also be considered when the site is selected.

After the incision has been made and the muscle identified, the doctor takes the muscle sample. You may feel a brief and mild discomfort as this is done. The sutures (stitches) which the doctor uses to close the incision will dissolve so they do not need to be removed. Small paper tapes will be placed over the incision to keep the skin together. These tapes can be removed after 7-10 days. A sterile dressing is applied over the paper tapes. This dressing stays on for 7-10 days also.

Nerve
The nerve biopsy takes about 1 hour. The incision is made above the outer ankle bone (which is the sural nerve) and is about 5 inches. The rest of the procedure is similar to the muscle biopsy. When the nerve is clipped, you may feel an electrical sensation. A pressure dressing, by use of an ace wrap, will be placed on the site. The pressure dressing will be on for the first 24 hours to avoid bleeding and swelling.

Care of the Site
Remember to keep your incision dry for the first 7 to 10 days. To take a shower or bath you must do one of the following to keep the site dry:

1. Take a sponge bath at the sink;
2. hold your arm out of the water if the site is your arm;
3. cover the area with plastic sheeting (plastic wrap or garbage bags), and tape it with plastic tape that is available at your drug store.

After the 7-10 days, the dressing may be removed and the biopsy site should be healed enough to resume bathing in your usual manner. Avoid excessive use of the biopsied muscle or nerve for the first 12 days. If your leg is involved, stay off your feet as much as possible for the first 24 hours. If you must be up and about, you should consider using crutches. Keep your leg elevated whenever possible the first 24 hours. If your arm is involved, limit its use the first 24 hours. Because you need to limit your activity, you may want to ask the doctor about a work release. Limiting your activity will minimize the pain and any chance of bleeding.

Ask your doctor what you should take for pain. In most cases acetaminophen (Tylenol) will take care of any pain. If you remain in the hospital, the doctor may change the dressing and check the biopsy site.

Complications
Although this procedure has few complications, please call your doctor or the Neurosurgery Clinic if you have any of these problems:

1. Pain after the first 72 hours
2. Redness or swelling around the incision
3. Drainage other than a small amount of fluid during the first 24 hours

The Neurosurgery Clinic phone number is (319) 356-2237. The clinic is open Monday-Friday from 8 a.m. to 5 p.m. After 5 p.m. or on weekends call the University Hospital Operator at (319) 356-1616 and ask for the neurosurgery resident on call.

See related Patient Textbooks about Neurosurgery.

See related Patient Topics Brain and Nervous System, Laboratory Tests, Neurologic Diseases--General, Neurosurgery or Procedures and Therapies.

See related Provider Textbooks about Neurosurgery.

See related Provider Topics Brain and Nervous System, Laboratory Tests, Neurologic Diseases--General, Neurosurgery or Procedures and Therapies.

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