Background: Peripheral neuropathy is a common neurological disease encountered by neurologists today. The role of nerve biopsy remains ambiguous, and the challenge of identifying the underlying etiology adds to the uncertainty. However, ruling out certain etiological causes and confirming specific diagnoses still necessitates the procedure.

Aim: This study aims to evaluate the contribution of nerve biopsy in peripheral neuropathies and examine the histomorphological spectrum of these biopsies.

Material and Methods: A retrospective two-year review of 54 nerve biopsies received in the Department of Pathology was conducted at a tertiary care center.

Results: A total of 54 nerve biopsies were reviewed during the study period, of which 6 biopsies (11%) were deemed inadequate. Biopsies were broadly categorized into those supportive for patient management and those essential for patient management. Biopsies essential for patient management (n=16) included vasculitic neuropathy (n=9), lepromatous neuropathy (n=4), hereditary motor sensory neuropathy (n=1), and CIDP (n=2). Biopsies supportive for patient management (n=14) included axonal neuropathies (n=6), demyelinating neuropathies (n=5), and mixed neuropathies (predominantly axonal with secondary demyelinating features, n=3). No diagnostic pathology was identified in 13 cases (24%).

Conclusion: With the advent of molecular tests and electrophysiological examinations, nerve biopsy is losing its prominence. However, its contribution remains significant in specific etiologies such as vasculitic neuropathy, lepromatous neuropathy, and, to some extent, in the management of CIDP. Increased awareness among pathologists of histomorphological features is essential to aid physicians in managing these patients.

Keywords: Nerve biopsies, Axonal neuropathy, Demyelinating neuropathy, CIDP

Dr. Ashmeet Kaur completed her MD in Pathology in 2015 at the age of 28. She is currently pursuing a PhD in Molecular Pathology from RUHS, Jaipur, which she began in 2023. Dr. Kaur has been specializing in Neuromuscular pathology and Molecular techniques at SMS Medical College, Jaipur since 2018. Her expertise encompasses muscle biopsies, nerve biopsies, routine histopathology, cytology, and hematology. She has undertaken extensive training in advanced molecular techniques and neuropathology, including short-term training programs under renowned specialists at AIIMS, New Delhi,  CSIR-IGIB, New Delhi, and NIMHANS, Bengaluru.

Dr. Kaur has significantly contributed to the establishment of a Nerve & Muscle lab, and Molecular Lab at SMS Medical College, Jaipur. Her research interests focus on Neuromuscular disorders, Neuropathies, and  advanced molecular techniques, particularly colorectal cancer mutations. She has authored numerous publications, presented papers at various national and international conferences, and received several awards for her contributions to Pathology. She is an active member of several professional organizations, including IAPM and IMA, and is involved in various ongoing research projects in her field.