Wallerian Degeneration

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Clinically Relevant Anatomy

Wallerian degeneration is an active process of retrograde degeneration of an axon that is a result of a nerve lesion.

Usually the rate of degeneration is slower in the Central Nervous System than peripheral Nervoius system due ggto the clearance of mylein sheets.

Mechanism of Injury / Pathological Process

The pathological process of a walleroian degeneration is in 4 stages;

• Axon Degeneration; Within approximately 30 minutes of injury, there is a separation of the proximal and distal ends of the nerve. After a short latency period of the transected membranes are sealed until degeneration. This is marked by the formation of axonal spheroids. The degeneration process is usually slower in the CNS and shorter in PNS
• mylien Clerance
• regeneration

https://www.youtube.com/watch?v=EcX7DWjC-7o

Clinical Presentation

Most patients have presentations of nerve damage as the nerves are degenerated.

These presentations may include[2]

• Paralysis of associated structures to denervated nerves
• Gradual onset of numbness, prickling, or tingling in your feet or hands, which can spread upward into your legs and arms
• Sharp, jabbing, throbbing, freezing, or burning pain
• Extreme sensitivity to touch
• Lack of coordination and falling
• Muscle weakness or paralysis if motor nerves are affected
• Neuromatous or causalgia pain

Diagnostic ProceduresElectromyography

• Nerve Conduction Studies
  • Pain assessment
  • Sensation deficit and skin condition
  • Muscle strength/loss
  • Functional deficits
  • Balance deficits
  • Joint stiffness
  • Emotional stress Outcome M
    

Outcome Measures

Depends on various criteria but could include:

• Oxford scale
• Romberg or Berg balance test
• Visual analogue scale
• Short form McGill pain questionnaire
• Nine-hole peg test

(see Outcome Measures Database)

Management / Interventions

Cryotherapy,

Differential Diagnosis

add text here relating to the differential diagnosis of this condition

Resources

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