4Regeneration-and-degeneration-of-nerve-fiber-1

DR.
SHAISTA SAIYAD
(MD, Ph.D., ACME, FAIMER)
Comprehensive
textbook of
Physiology,
Dr. G K Pal.
COMMON CAUSES OF DEGENERATION:
- TRANSECTION
- CRUSHING
- TOXINS OR POISONS
- ISCHEMIA
- HYPERPYREXIA
 First degree: temporary direct pressure over
nerve=ischemia
 2nd degree: severe pressure over nerve with
endoneurium intact
 3rd degree: severe pressure with damage to
endoneurial tube
 4th degree: damage to endoneuial tubes with
disorganisation of fascicles
 5 th degree: through and through cutting of
nerve.
Seddon’s Classification
1) Neuropraxia (like 1 degree)-

Only loss of function, no anatomical damage
2) Axontemesis (like 2 degree)-

Injury upto axis cylinder
3) Neurotemesis (like 3 degree)-

Injury of whole nerve is injured means upto endoneurial
tube
 In
nerve cell body (retrograde
degeneration)
 In the proximal stump
 In
distal stump (wallerian
degeneration)
 Transneuronal degeneration
Degeneration in distal stump is called
Wallerian (antrograde) degeneration
Degeneration in proximal stump

Retrograde degeneration
Injured neuron can lead degeneration in

the other neuron it is connected to
Transneuronal degeneration
Comprehensiv
e textbook of
Physiology,
Dr. G K Pal.
1,2,3,4 &5 day after injury
-1day- distal stump degenerative changes begin
-2 day- cell body degenerative changes begin
-3 day- the ability of axon to conduct impulse decreases
-4 &5 - nerve or axon fails to conduct any impulse
20 days- 2 to 3 months- 2 years

Degeneration begin at 1 day continue upto 20 days
Regeneration begin from 20 days to 2 to 3 months but
functional recovery continue upto 2 years (max upto 80%)
DEGENERATION
Duration-
Start from first day & reach max.

in 20 days.
Changes in nerve cell bodies-
- Within 48 hours after the section of the nerve,
- cell body swells
- there is chromatolysis,
- nucleus comes to margin of the cell,
- other organelles also fragments etc.
Changes in proximal stump-

Changes are same as distal stump but they occur
only upto nearest node of Ranvier from site of
injury.
CHANGES IN DISTAL STUMP-
- Axis cylinder swells & breaks into pieces.

- Myelin sheath breaks into oily droplets.
- Macrophages come from endoneurium to
degenerating
myelin sheath & axis cylinder & clear the debris
- Only empty endoneural tubes called ghost tube
remain
- Schwann divide & fill the tube with cords of cells
 Distance of injury to the cell body.
 Gap bet. two ends:3 mm.
 Two cut ends remain in same line.
 Intact neurilemma is a must for regeneration.
Axons in CNS do not have neurilemma, hence
cannot regenerate.
 If the type of injury is sharp cut, damage is less
compared to crushing injury.
 If the cell body is damaged, neuron dies.
 In nerve cell body
 In the distal stump
Factors on which regeneration depends:

1) Severity of injury
2) Condition of soma
3) Site of injury
4) Neurotropins: nerve growth factors
Regeneration-
I) prerequisites & duration-
- Gap between cut ends should be less than 3

mm.
- Nucleus should be present,
- Neurilemma should be present.
Myelination continue upto 1 year and while

functional recovery takes longer time (upto 2
years)
Comprehensiv
e textbook of
Physiology,
Dr. G K Pal.
Changes In proximal and distal stump-
- 100 fibrils elongates from proximal stump (0.25

mm/day)
- 20 fibrils enter into distal stump
- Now only 1 fibrils grow rapidly (4 mm/day) to

form axis cylinder all other degenerate.
- Schwann cells fill the endoneural tube form

myelin sheath around the successful fiber.
80% of original diameter may be achieved
Changes in cell body-
Nissl’s granules & Golgi apparatus reappear. Cell

regains its usual size and nucleus returns to
the central position.
APPLIED
Neuroma-
If during the regeneration of the nerve fibrils,

arising from proximal cut end, not find their
way or if the gap is too large,
the fibrils elongate, turn round & form whorl-like
painful mass known as neuroma.
Phantom limb-
- When the limb is amputated,

- Neuroma develops at the site which gives the
unpleasant sensation of phantom limb,
- Excitation at the site of amputation causes the
patient to feel that lost limb is still present.
Tinel's sign
Tingling sensation , when percussion is made over

the nerve.
It indicates the beginning of regeneration of the

nerve.
THANK YOU

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DR.

1) Neuropraxia (like 1 degree)-

2) Axontemesis (like 2 degree)-

3) Neurotemesis (like 3 degree)-

 In the proximal stump

Degeneration in proximal stump

Injured neuron can lead degeneration in

20 days- 2 to 3 months- 2 years

Start from first day & reach max.

Changes in proximal stump-

- Axis cylinder swells & breaks into pieces.

Factors on which regeneration depends:

I) prerequisites & duration-

- Gap between cut ends should be less than 3

Myelination continue upto 1 year and while

- 100 fibrils elongates from proximal stump (0.25

- 20 fibrils enter into distal stump

- Now only 1 fibrils grow rapidly (4 mm/day) to

- Schwann cells fill the endoneural tube form

Nissl’s granules & Golgi apparatus reappear. Cell

If during the regeneration of the nerve fibrils,

- When the limb is amputated,

Tingling sensation , when percussion is made over

It indicates the beginning of regeneration of the

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