Muscle and nerve biopsies: techniques for the neurologist and neurosurgeon.

OBJECTIVE: Muscle and nerve biopsies are commonly performed procedures for the diagnosis of neuromuscular disorders. Neurologists and neurosurgeons are often consulted to perform these procedures in clinical practice. We provide guidelines in the performance of muscle and nerve biopsies. METHODS: We describe the technique for performance of muscle and nerve biopsy, and review the relevant literature. RESULTS: The quadriceps muscle is the most typical biopsy site for most myopathies, whereas the sural nerve is the most common nerve biopsy site for most peripheral neuropathies. Other sites may be utilized depending upon the pattern of symptoms or the differential diagnosis. Motor nerves may be sampled in the setting of motor neuron disease, for example. We advocate the use of conduit repair to allow for sensory or motor recovery to occur following nerve biopsy. CONCLUSION: The muscle biopsy and nerve biopsy may be performed with high yield, low morbidity, and rare complications.