Peripheral Nerve Injury

Peripheral Nerve Lesion

We utilize a wide range of treatment modalities from microsurgical techniques at the lesioned nerve site to nerve grafting procedures that have been rigorously scrutinized and proven effective to help our patients achieve the best functionality restoration results possible.

Immediately after injury (in case of blunt trauma):

Physiotherapy including muscle and nerve stimulation programmes and passive exercises should be emphasized to keep the muscles and joints flexible and functionally alive. Some patients show improvement or recovery within six weeks to three months after the injury. These patients are typically treated with conservative therapy to improve their range of motion and muscle strength, preventing joint stiffness and deformity.

Non invasive treatment

may be a simple recommendation to maintain active use of an affected extremity, or a complex detailed physiotherapy regimen involving splinting, lymph-massage, ultrasound, electro stimulation, and manual therapy, etc. Improvement of brain plasticity processes after surgery, e.g. re-learning sensibility and/or learning new functional muscle modalities is also included.

If no signs of recovery are detected our team will initiate a highly individualized algorithm to indicate an operative procedure.

Invasive treatments

range from the minimally-invasive decompression techniques to complex and lengthy microsurgical brachial plexus reconstruction and tumor excision procedures using all available sources of nerve fibers which can be transferred to patient’s needs.

It is crucial that the procedure of nerve surgery is chosen according to a patient’s individual needs and is part of a global comprehensive treatment including very individual functional restorative and/or reconstructive or palliative procedures. All our efforts are geared towards maximizing peripheral nerve reconstructions including strategies in secondary restorative and palliative procedures.

This individually designed comprehensive package of treatment achieves maximum results for patients suffering from these peripheral nerve lesions.

Helping the Brain to re-organize

Peripheral nerve injury like brachial plexus lesion results in deafferentiation of the representative brain areas. This means that due to the traumatically affected nerves no signals are passed from the periphery to the central nervous system.

Re-organization of those brain regions starts and can be positively influenced by promoting brain plasticity which shows the vast possibilities inherent in the human brain, e.g. an intension triggered myo-feedback therapy (IMF-Therapy) for improvement of muscle activity and sensibility resulting in pain reduction which was first introduced in peripheral nerve treatment at the Millesi Center.

Moreover, we have introduced a sensory re-learning programme immediately after peripheral nerve injury to preserve the brain’s mapping of the individual body image (virtual sensibility programme for re-learning sensibility).

This therapy is crucial during time-consuming peripheral nerve regeneration where no sensation is present. Re-learning of sensory and motor activities on the basis of peripheral and central nervous system cooperation is introduced to our patients carefully. These activities will result in useful functional regeneration processes in the peripheral and central nervous system.

Our efforts with non-operative and operative procedures are dedicated to promoting these functionally oriented optimized regeneration processes.