Pediatric Nerve Injuries

Q: Are nerve injuries permanent?

Nerves have the ability to grow back, but sometimes the damage is too severe. Unfortunately, extensive, severe nerve damage – like the kind that causes paralysis – is irreversible.

Q: What is a nerve scar?

A nerve scar, or neuroma, occurs when nerve fibers try to grow at the site of an untreated, severed nerve. Nerve fibers grow into a ball of scar tissue at the end of the nerve. A nerve scar can cause nerve pain that feels like an electric shock. Your child may need surgery to remove the scarred area.

Nerve injuries affect your child’s ability to move muscles and experience sensations. They can also cause pain, tingling or numbness. At Children’s Health℠, we bring together experts from several specialties to treat all types of pediatric nerve injuries.

Overview

What are pediatric nerve injuries?

Nerve injuries occur when there’s pressure, stretching or cutting of nerves that make up your child’s nervous system. Nerves act as the body’s wiring system. They carry messages from your child’s brain to other parts of their body.

Nerve injuries can affect:

Motor nerves. These nerves send messages to your child's muscles to make them move.
Sensory nerves. These nerves help your child feel pain, pressure, heat, cold and other sensations.

A nerve injury can stop signals from going to and from the brain. Depending on the nerve injury, your child may not be able to make certain movements. Or, they may lose feeling or have pain in the injured area.

Types

What are the different types of pediatric nerve injuries?

Nerve injuries can occur anywhere in the vast network of nerves running throughout your child’s body. Common types of pediatric nerve injuries include:

Acute flaccid myelitis (AFM)
Brachial plexus birth injuries
Carpal tunnel syndrome and other nerve compression syndromes
Neurofibromatosis (NF)
Spinal cord injury
Transverse myelitis
Traumatic nerve injury

Signs and Symptoms

What are the signs and symptoms of pediatric nerve injuries?

Muscle weakness
Numbness or loss of sensation
Peripheral neuropathy (pain, burning or tingling)
Skin color changes

Signs and symptoms of a nerve injury vary depending on the cause, affected nerve and severity of the nerve injury. Your child’s symptoms may be constant or come and go.

Diagnosis

How are pediatric nerve injuries diagnosed?

Our team may diagnose a nerve injury based on a physical exam and your child's symptoms. If the nerve injury is severe, your child may get advanced diagnostic tests, such as:

MRI to look for compressed, torn or damaged nerves
Nerve conduction studies, such as electromyography (EMG), to check the signals between muscles and nerves

Causes

What causes pediatric nerve injuries?

Nerve fibers called axons separate into bundles in your child’s nerves. Layers of tissue surround these bundles, insulating and protecting nerve fibers. Nerve injuries can affect the nerve fibers, the insulation or both.

Potential causes of nerve injuries include: fractures, dislocations, and crush injuries

Cuts
Dislocations (bones in joints that are knocked out of place)
Fractures and casts
Infections
Injuries that cause compression, stretching or tearing
Trauma, such as electrical shock, falls, accidents and gunshot wounds

Treatment

How are pediatric nerve injuries treated?

Some minor nerve injuries heal with proper resting of the injured area. Your child may need to wear a cast, splint or sling during this time. Our doctors closely monitor your child to ensure the injured nerves heal as they should. Damaged nerves can take several months, or sometimes more than a year, to fully recover.

For more serious nerve injuries, your child may require one or more of these treatments:

Pain management

Children who have nerve pain that prevents them from doing their usual activities may see experts at our Chronic Pain Clinic. Your child may benefit from:

Nerve blocks: A doctor injects medication near the injured area. A nerve block can reduce swelling and take pressure off the nerve to ease pain.
Pain medications: Our pain specialists and pharmacists help find the right medicines to ease your child’s pain with few side effects.
Psychological support: Our psychologists use cognitive behavior therapy (CBT), hypnotherapy and other methods to help children cope with chronic nerve pain. These methods also ease the stress and anxiety that often come with chronic pain.

Electrical stimulation

Electrical stimulation is a treatment that sends mild electrical impulses to your child's muscles. The treatment doesn’t hurt. It helps restore communication between injured nerves and the muscles they control.

Nerve surgery (neurosurgery)

Our highly skilled pediatric neurosurgeons perform complex surgical procedures to repair injured nerves. U.S. News & World Report rates our neurology and neurosurgery departments among the best in the country. We have the expertise to treat nerve injuries and help your child regain movements and sensations.

Depending on the nerve injury, surgery options include:

Nerve decompression. If your child has a compressed nerve, we perform surgery to open the space around the nerve. This procedure takes pressure off the nerve.
Nerve graft. When necessary, our doctors take a section of a nerve from a different part of your child’s body to “patch” a torn nerve.
Nerve repair. Your child’s surgeon reconnects torn or cut nerves, allowing new nerve fibers to grow.

Physical and occupational therapy

Physical therapy and occupational therapy exercises keep joints flexible and strengthen muscles while nerves heal. Your child may do one or both therapies instead of or after surgery. Our therapists also help your child with sensory reeducation exercises. This therapy improves feeling and sensations in injured hands or fingers. Our team shows you and your child how to do physical and occupational therapy exercises at home.