waldoputty
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This is an article that answers some of our questions in reference to Jaylon's update. I will try to get more information from a couple researchers today or tomorrow.
This is original text from US NIH on nerve regeneration. This is general nerve regeneration, not just peroneal nerve injury for Jaylon's case. After the text, I will translate as well as I can for relevant facts:
"EMG testing can be used to demonstrate neurological recovery."
"True axonal regeneration occurs at the site where the nerve has been injured and where axonal degeneration begins [2]. For axonal regeneration to occur, there must be an intact anterior horn cell also known as the motor neuron cell body and an intact channel for regeneration, the endoneurial tube. When axonal injury occurs, the axon distal to the site of injury undergoes Wallerian degeneration, whereas the proximal axonal component usually remains intact. The proximal axon forms a bud that begins to regenerate distally through the endoneurial tube toward the denervated muscle. This process occurs at a rate of 3–4 mm/day so axonal regeneration is length-dependent [3, 4]. Neurological recovery is also dependent on healthy viable muscle tissue. This is necessary for the release of nerve growth factors from denervated muscle. These factors act as a catalyst to stimulate the axon to regenerate. If the denervated muscle becomes fibrotic, these factors may no longer be released. Muscle tissue must also remain viable and electrically active if a regenerating axon is going establish a connection with a functional neuromuscular junction. Chronically denervated muscle will eventually become fibrotic and electrically inactive. This usually happens somewhere between 18 and 24 months."
Take Away Facts:
1. EMG testing can be used for testing nerve regeneration. They are using this with Jaylon and the updates include EMG results are improving. That is a good thing.
2. From other info - there are 2 types of regeneration needed - (1) Regrowing the 6" of the nerve cell that died after the injury and reinnervation of the muscle. (2) Reinnervation of the muscle once the regrowth gets to the muscle.
3. The nerve cell nucleus itself (above the knee) is fine or there would be no regrowth and everyone would be crying already.
4. Regrowth of the nerve axon is 3-4 mm per day. If the growth is having problems, there are surgical options. Since there has been no additional surgery, the regrowth is/did not having major problems.
5. If the nerve takes more than 18-24 months to get to the muscle, we are in trouble because the muscle changes. We are at month 10.
This is original text from US NIH on nerve regeneration. This is general nerve regeneration, not just peroneal nerve injury for Jaylon's case. After the text, I will translate as well as I can for relevant facts:
"EMG testing can be used to demonstrate neurological recovery."
"True axonal regeneration occurs at the site where the nerve has been injured and where axonal degeneration begins [2]. For axonal regeneration to occur, there must be an intact anterior horn cell also known as the motor neuron cell body and an intact channel for regeneration, the endoneurial tube. When axonal injury occurs, the axon distal to the site of injury undergoes Wallerian degeneration, whereas the proximal axonal component usually remains intact. The proximal axon forms a bud that begins to regenerate distally through the endoneurial tube toward the denervated muscle. This process occurs at a rate of 3–4 mm/day so axonal regeneration is length-dependent [3, 4]. Neurological recovery is also dependent on healthy viable muscle tissue. This is necessary for the release of nerve growth factors from denervated muscle. These factors act as a catalyst to stimulate the axon to regenerate. If the denervated muscle becomes fibrotic, these factors may no longer be released. Muscle tissue must also remain viable and electrically active if a regenerating axon is going establish a connection with a functional neuromuscular junction. Chronically denervated muscle will eventually become fibrotic and electrically inactive. This usually happens somewhere between 18 and 24 months."
Take Away Facts:
1. EMG testing can be used for testing nerve regeneration. They are using this with Jaylon and the updates include EMG results are improving. That is a good thing.
2. From other info - there are 2 types of regeneration needed - (1) Regrowing the 6" of the nerve cell that died after the injury and reinnervation of the muscle. (2) Reinnervation of the muscle once the regrowth gets to the muscle.
3. The nerve cell nucleus itself (above the knee) is fine or there would be no regrowth and everyone would be crying already.
4. Regrowth of the nerve axon is 3-4 mm per day. If the growth is having problems, there are surgical options. Since there has been no additional surgery, the regrowth is/did not having major problems.
5. If the nerve takes more than 18-24 months to get to the muscle, we are in trouble because the muscle changes. We are at month 10.
