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What Is Neurapraxia?

Medically Reviewed by Poonam Sachdev on November 22, 2021

Neurapraxia is a mild form of nerve damage that can lead to temporary motor and sensory loss. 

Neurapraxia is the mildest form of peripheral nerve injury (PNI). There are five different levels of PNIs—grades I through V. The difference between these levels is based on an increasing amount of nerve damage. 

Grade 1 PNIs are called neurapraxia. In these cases, the actual nerve axon—the long part of the cell that conducts electrical signals—and all of the surrounding connective tissue aren’t damaged. 

The symptoms of neurapraxia are caused by a block that forms along the nerve and keeps electrical signals from passing. Until this block is cleared, the damaged region is cut off from communicating with other parts of the nervous system.  

Neurapraxia is the most common form of nerve damage. PNIs are underreported, but approximate rates are about 13 to 23 cases per 100,000 people per year.  

What Causes Neurapraxia?

The two main causes of neurapraxia are compression and ischemia—a low blood supply to a tissue or region. Inflammation is a common general cause. 

Researchers don’t know exactly how nerves become blocked, but you’re more likely to develop neurapraxia in nerves that pass through narrow openings within your body. 

Neurapraxia is a common surgical complication. In surgery, it’s typically caused by: 

  • Poor body placement during surgery
  • Poor padding on body supports
  • The use of tourniquets and select other surgical equipment
  • Complications from anesthesia, caused by either chemical nerve damage or a narrowing of your blood vessels that leads to your blood supply getting cut off 

Some surgeries are more likely to cause neurapraxia than others. For example, there’s a 75% chance of neurapraxia in all anterior cruciate ligament (ACL) reconstruction surgeries but less than a 1% risk in hip replacement surgeries.

Neurapraxia also happens to very specific nerves near and in your mouth during some dental situations, including: 

  • Certain molar extractions
  • Oral diseases
  • Injections of anesthesia 

Other possible causes of neurapraxia outside of a medical setting include: 

  • Car accidents
  • Sports injuries 
  • Falls
  • Gunshot wounds

If the neurapraxia happens outside of a medical setting, it’s important for you to tell your doctor the exact timing of the accident compared to when you first noticed your symptoms. This will help them figure out how the damage is progressing and whether it’s likely caused by compression or loss of blood.

What Are the Symptoms of Neurapraxia?

Symptoms of neurapraxia will depend on which of your nerves is blocked and where. They can include: 

  • Weakness
  • Pain
  • Touch sensitivity 
  • Loss of sensation
  • Loss of motor abilities
  • Tingling
  • Numbness

The symptoms from neurapraxia might not appear immediately after the injury. Symptoms could even take weeks to appear. In this case, the cause is usually inflammation that’s compressing the nerve and causing the damage. 

Neurapraxia that’s caused by compression usually forms the neural blockage slower and symptoms last for a longer time than neurapraxia caused by blood loss. When it’s caused by blood loss, the blockage and symptoms both develop and clear up faster.  

How Is Neurapraxia Diagnosed?

Neurapraxia—and all kinds of traumatic peripheral nerve injury—are difficult to diagnose. This means that cases are commonly underreported. 

There are nerve conduction tests that your doctor can perform, though, to find out the exact location of the block along a particular nerve. The tests slowly narrow in on a region where the electrical signal can’t move further down your nerve. 

Some imaging tests—such as magnetic resonance imaging (MRIs)—might be needed to make sure that there isn’t even more severe nerve or tissue damage that’s actually causing your symptoms. 

What Is the Treatment for Neurapraxia?

A lot of the time, you won’t need any special treatment for neurapraxia. The nerve damage will heal on its own if left alone for days to weeks. 

Other possible treatments include: 

  • Pain relievers
  • Resting the affected area 
  • Avoiding the aggravating activity
  • Switching to new equipment or adding padding to existing equipment. For example, athletes may need to modify training items or wear braces.

Neurapraxia Prognosis

Recovery rates are very good for neurapraxia. The nerves should be able to heal themselves within 1-4 weeks. At this time, you’ll have completely recovered all sensations and functions.  

Keep your doctor informed of how your neurapraxia is healing. They’ll want to make sure that you recover all sensory and motor skills in a timely manner.

Show Sources

SOURCES:
Biso, G.M.N.R., Munakomi, S. StatPearls, “Neuroanatomy, Neurapraxia,” StatPearls Publishing, 2021.

International Congress of Oral Implantologists: “Neurapraxia.”

Neurology: “February 13, 2014 e-Pearl of the Week: Neurapraxia.”

Science Daily: “Axon.” 

Science Direct: “Neurapraxia.” 

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