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Seddon classification of nerve injuries

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Sir Herbert Seddon in 1942 described a scheme for describing nerve injuries according to the extent of damage to axons and surrounding connective tissue layers. It has clinical relevance in that it indicates the likely prognosis:

  • neuropraxia:
    • no anatomical disruption
    • a localised, physiological and transient conduction block along a nerve
    • usually a result of a blunt injury
    • no distal Wallerian degeneration occurs
    • very variable, but often a motor paralysis with some residual sensory or autonomic function
    • nerve conduction studies show a conduction block at the level of the injury
    • typically, there is recovery in days to weeks
    • a diagnosis of exclusion
  • axonotmesis:
    • axonal damage within the nerve
    • axonal degernation but endoneurial tubes and surrounding connective tissue elements remain intact
    • distal Wallerian degeneration
    • often the result of a more intensive blunt injury
    • full recovery is usual but may take weeks to months; there may be a residual deficit
  • neurotmesis:
    • nerve divided
    • usually violent, open injuries
    • all axons and connective tissue elements disrupted
    • Wallerian degeneration distally
    • some recovery possible but much more likely with surgical nerve repair
    • full recovery unlikely
 
General Practice Notebook
General Practice Notebook
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