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The Axon: Normal Structure and Pathological Alterations

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Biopsy Diagnosis of Peripheral Neuropathy

Abstract

The most common nerve biopsy findings are nonspecific axonal alterations such as axonal degeneration, depletion, and regeneration. The pathologist can assess the severity and chronicity of the damage, but infrequently can find an unequivocal structural indication of its underlying cause. Two major patterns of axonal disease can be identified: those changes indicating a disturbance of axonal metabolism (axonopathy) and those changes indicating axonal degeneration (Wallerian degeneration). Although electron microscopy provides a more detailed view of normal and pathological features than light microscopy, the stereotyped changes of Wallerian degeneration or axonopathy represent one final common pathway of disease and do not permit specific diagnosis of the underlying etiology. Only rarely do axonal alterations have specific implications, for example, giant axonal swellings with filamentous accumulations or the classic features of neuroaxonal dystrophy.

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Authors and Affiliations

  1. Sunnybrook and St Michael’s Hospitals, University of Toronto, Toronto, ON, Canada

    Juan M. Bilbao MD, FRCP (C) (Professor Emeritus of Neuropathology)

  2. Division of Neuropathology Department of Pathology, Washington University School of Medicine, St. Louis, MO, USA

    Robert E. Schmidt MD, PhD (Professor of Pathology and Immunology Director)

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  1. Juan M. Bilbao MD, FRCP (C)
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  2. Robert E. Schmidt MD, PhD
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Bilbao, J.M., Schmidt, R.E. (2015). The Axon: Normal Structure and Pathological Alterations. In: Biopsy Diagnosis of Peripheral Neuropathy. Springer, Cham. https://doi.org/10.1007/978-3-319-07311-8_4

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