Wallerian Degeneration

Original Editor - Anthonia Abraham
Top Contributors - Anthonia Abraham, Kim Jackson, Cindy John-Chu and Lucinda hampton

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 the peripheral Nervous system due to the clearance rate of myelin.

Mechanism of Injury / Pathological Process

The pathological process of a Walle 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

Clinical Presentation

Most patients have presentations of nerve damage.

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 Procedures

Electromyography

Nerve Conduction Studies

Pain assessment

Sensation deficit and skin condition

Muscle strength/loss

Functional deficits

Outcome Measures

Depends on various criteria including pain and psychosocial skills but could include:

• Oxford scale
• Visual analogue scale
• Short form McGill pain questionnaire

(see Outcome Measures Database)

Management / Interventions

Wallerian Degeneration is a nerve repair mechanism. Managing nerve damage can include the use Cryotherapy, Exercise,

Resources

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