An electron microscope study of chronic median nerve compression in the guinea-pig

Summary

In guinea-pigs with chronic median nerve compression at the wrist the electron microscopic changes at level of the lesion and both proximal and distal to it have been studied. At the level of the lesion in animals with prolonged motor latency there was a loss of large myelinated fibres. Remaining large fibres had disproportionately thin myelin sheaths or were demyelinated. Regenerating clusters containing myelinated fibres were present. Evidence of degeneration and regeneration of unmyelinated fibres was present in the more severely affected nerves of this group. Distal to the wrist myelinated fibre density recovered, with regenerating clusters and many axons having disproportionately thin myelin sheaths. Midforearm and upper arm levels were normal.

In nerves in which no muscle response to electrical stimulation could be recorded in the palm, a few fibres devoid of myelin remained at the wrist. Immediately proximal to it myelinated fibres were rare, the main feature being Schwann cells containing axons devoid of myelin some of which were degenerating. Degeneration of myelinating fibres within regenerating clusters was seen. At the mid-forearm level large myelinated fibres were reduced and increased numbers of regenerating clusters were seen. Evidence of regeneration of unmyelinated fibres was found. The upper arm was normal.