Peripheral Nerve Biopsy

Fresh and fixed peripheral nerve tissue (typically sural nerve) obtained by open biopsy.
Three specimens are requested:

1. for paraffin sections, a 2cm segment of nerve tied at both ends with suture, then tied (taut, but not overstretched) onto a length of wooden tongue depressor, and placed in Heidenhain-Susa fixative (or 10% neutral buffered formalin);
2. for electron microscopy and teased fiber preparation, a 2cm segment of nerve, clamped in situ in a Price (metal) or Rayport (plastic) muscle biopsy clamp, excised, and immersed in 3% glutaraldehyde (or 10% buffered formalin) in a sealable container;
3. for frozen sections, a 1cm segment of fresh nerve on a saline-moistened gauze pad, then placed in a sealed specimen container, which in turn is placed in ice (not dry ice). Label each container with the patient's name, medical record number or your surgical pathology accession number, and the biopsy site.

A completed Neuromuscular Pathology Request Form, including patient demographic information, relevant clinical and laboratory test information, and clinician contact information must be submitted with the specimen. Have the specimen transported to the laboratory within 2 hours. If anticipated transport time will exceed 2 hours, or if the specimen cannot be delivered by 3:00 p.m. on a weekday, call the Neuropathology Laboratory for instructions.

Optionally, a protocol can be provided for freezing specimens at a remote site prior to transport to the Neuromuscular Pathology Laboratory by an appropriate carrier (e.g., Federal Express). A nerve biopsy kit that includes containers, gauze, saline, fixatives, a sterile Rayport biopsy clamp, a Veripath Neruopathology Requisition Form, biopsy instructions, and a transport container is available upon request from the laboratory. Call in advance to request a kit, preferably 24 hours in advance. Referral to a UT Southwestern surgeon experienced in peripheral nerve biopsy technique can be provided upon request. Call the Neuropathology Division for referral (see Contact information below).