Nerve Regeneration – Everything You Need To Know – Dr. Nabil Ebraheim



Educational video describing the process of motor neuron injury and regeneration.
Peripheral nerves have the ability to regenerate. The injured nerve fiber (Axon) is very long and it has to regenerate and reach its target in a reasonable time so that the patient can have a good function. The nerve has protective layers of tissue surrounding it:
•Epineurium: surrounds the nerve itself •Perineurium:L around the fascicle •Fascicle •Nerve fiber •Endoneurium: around the axon •Myelin sheath •Axon
The neurons become stimulated at the dendrites. Neurons possess structures that allow for the transmission of impulses and are composed of two parts:
•Receiving structures: dendrites, cell body •Conducting structures: axon, axon terminal.
Signals from the brain are passed on to the muscles in the limbs by these motor neurons.
When painful stimulus is applied to a sensory receptor in the skin (afferent), the information is transmitted to the central nervous system (CNS). Once the sensory signal has been received by the CNS, another signal is then sent from the brain (efferent) and passed along the motor neurons in order to move the muscles in response to painful stimulus.
When the nerve is affected or cut, there will be no function of that nerve. When the axon is separated from the body, there will be degeneration of the axon and the degeneration will stop at the synapse and will not travel to the next neuron. Regeneration of the peripheral nerves is possible and all events of regeneration occur around the axon when the nerve is cut. The proximal stump will regenerate and the distal stump will have Wallerian degeneration. Macrophagocytes dispose of the degenerated axon and myelin sheath. Schwann cells grew into the cut area and join the two ends. The entire axonal material is phagocytized from the site of the injury to the endplate. Anew generated axon sprouts and grow to reestablish the connection from reaching its target.
•Wallerian degeneration: the neuron is able to survive and regenerate after the axon has been cut with neuronal survival and Wallerian degeneration. The Wallerian degeneration typically arises from severe nerve injuries such as axonotmesis or neurotmesis. The cell body increases in size with migration of the nucleus towards the cell periphery. The cell body enlarges for approximately 20 days and remains enlarged until axon regeneration is complete. In the proximal part of the nerve segment, degeneration can occur and it is proportionated to the severity of the injury. Degeneration extends proximally to the next node of Ranvier. Wallerian degeneration is seen in the distal portion of the nerve fiber.
•Synthesis of growth-promoting molecules: axonal degeneration is followed by degradation of the myelin sheath and infiltration by macrophages.the macrophages are accompanied by Schwann cells which clear the debris from degeneration. Distally you will find Schwann cells proliferate and the axon sprouts (finger like growths) and advance. Using Schwann cells as a guide, these sprouts advance about 1 mm per day. Atrophy of the associated muscle will be seen during the process.
•Regeneration & remyelination: axonal growth is seen and the connection is reestablished with the muscle appearing to be bigger and a bit healthier. When the axon fails to establish continuity, a neuroma formation will be seen with no regeneration of the axon distally. Atrophy of the associated muscle will be seen during the process.
There are three types of nerve injuries:
•Type I: neurapraxia: prognosis is good with neurapraxia and it’s the mildest form of nerve injury and the nerve remains intact.
•Type II: axonotmesis: injury is severe. The axon is damaged and the surrounding connective tissue is intact. There will be partial or complete recovery of the nerve and Wallerian degeneration occurs distal to the nerve injury site. Recovery occurs 1 mm per day or 1 inch per month.
•Type III: neurotmesis: no recovery, fibrillation is present and the injury usually requires surgery. Motor neuron unit potential is usually absent. In neurotmesis there will be degradation and neuroma formation.
EMG and nerve injury
•Degeneration (Wallerian): fibrillation
•Reinnervation(Axon sprouting re-establishment of the connection): polyphasic motor activity is good.
There are several factors that affect the success of recovery. If the gap between the proximal and distal stumps is too wide or scar tissue has formed, surgery can help to guide the sprouts to the tube.
Factors affecting favourable nerve recovery after repair:
•Younger age of the patient •Distal injury •No significant delay in repair •Sharp cuts are better than a crush •Vascularity is preserved •Favorable orientation of the nerve in epineural repair.
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25 thoughts on “Nerve Regeneration – Everything You Need To Know – Dr. Nabil Ebraheim

  1. PLEASE HELP ME! ARE THERE ANY CLINICAL TRIALS OR EXPERIMENTS FOR ME? I sustained an upper ulnar nerve injury on my left arm it messed my hand up really bad it seems like its permanent because a nerve graft of 2.5 inches did not work and the nerve transfer was a nightmare just made my hand weaker and left another scar im really sad! I HEARD STEM CELLS CAN BE INJECTED IN MY GRAFT!?? PLEASE HELP ME! 8 MONTHS AFTER MY NERVE GRAFT I FELT A CONNECTION FROM PROXIMAL TO DISTAL BUT IT ONLY LASTED FOR 1 DAY AND STOPPED! IT only worked for a day! TESTS were DONE AT 1.6 YEARS LATER AND NERVE CONDUCTIONS/ confirmed and SHOWED MY NERVE IS NOT SHOWING ANY REGENERATION SIGNS!! PLEASE HELP ME GET FEELING AND FULL FUNCTION OF MY HAND IM WILLING TO DO ANYTHING! NERVE TRANSFERS AND TENDON TRANSFERS SHOULD BE ILLEGAL THEY JUST MESS U UP MORE AND TRAUMATIZE U! I BEGGED MY DOCTOR TO REMOVE MY NERVE TRANSFER BECAUSE IT DIDNT FEEL RIGHT! HELP ME SOMEONE IM DYING INSIDE 😭😭😭😭😭😭😭😭😭😭😭 MY LIFE IS RUINED 🙁 MY EX CUT ME AND LEFT ME LIKE THIS IM SO SAD 🙁 ITS 2018 AND HUMANITY CANT SOLVE NERVE PROBLEMS WHY 😭😭😭😭😭😭😭😭😭😭 SOMEONE HELP ME 🙁 ALL THESE DOCTOR PLACES JUST DONT CARE! AFTER THEY DO SURGERY U BETTER HOPE U RECOVER IF NOT U ARE SCREWED 🙁

  2. BULLSHIT…… Doctors are dealers not healers……. Give me a break what the hell was that video….. OMG stop listening to the lies STOP……. Nerves heal even after years scar tissue can be dissolved eaten and spit out Be pro-active in your own health stop sitting around waiting for a miracle shot………… It takes time for the nerves to re-generate but they can Anyone that tells you you can't get better find someone else it's BS……… These doctors are being scientific…….. My father had major surgery of course there's scar tissue but he has no pain and he's 80 according to this doctor my father is to old to heal from nerve damage…… According to him my father should be living in chronic pain…….But he's not so right away I know one person who has proven this doctors opinion wrong my own dad…… Give me a break he's wrong give your body the nutrients it's screaming out for and watch miracles happen….. Juicing clean water veggies raw foods oxygen therapy (cd) Jim humble all of these combined will heal you Eat organic AL the best to those suffering I wish only health for all people everyone God bless…

  3. My father had 2 major surgeries 75 years old and 81 years old….. They cut him past his belly button in the same place for both surgeries he had no pain or numbness healed 100% if the nerves don't heal after severe damage then why did my father at his age especially heal with no permanent damage….. Why is everyone a liar no one wants anyone to get better everyone wants to hurt you….. Nerves can't heal bullshit they do heal even after being severed give me a break how many woman have c-sections 3 or 4 and heal the nerves no pain EVER….. Obviously nerve damage is NOT permanent and nerves do heal even after major damage…… Even at my dad's age ……. The doctors job is to take away your hope keep you sick anday in pain so your dependent on them for life….. Stop believing these con artists people run to these doctors as if they are God and all they do is lie to you and take your money see ya next month and you go back…… Nerves heal always feed the body nutrients and you will be shocked at how the nerve damage is cured and I mean forever…… People are brain washed by doctors and they say you can't heal nerve damage just lessen symptoms what the hell is that it's all over the Internet I never hear or read positive stories of healed or cured because people just give up and live with the pain because some A-hole doctor took away their hope…….. I wish people loved themselves more and changed their lifestyle so that their body can heal 100%…..

  4. Please help me!! I had back surgery and the surgeon botched the surgery and left me with extensive nerve damage that affects my back down to my toes. Ive lost everything my whole life because of this. Is there anything for me out there?!? Please help. Im 39yrs old

  5. this is complete bullshit and maybe correspnds to 5% of what really happens. Now doctor explain to us, how come some people who have for example lupus have nerve damage and actually plaques that follow the paths of nerves, is this because the nerve and axons got seprated? How about some other substance blocking the paths? which by the way would make way more sense since anyone who has peripheral; nerve damage sees the muscle damage affecting the extremities first not the spot where your so called ',separation'' point, why is that?

  6. Thank you, once again, for an excellent video! Can you provide information (a video) as the regeneration of the peripheral myelin sheath? With Guillain Barre Syndrome (GBS – Acute inflammatory demyelinating polyneuropathy and Chronic Inflammatory Demyelinating Polyneuropthy (CID), current and former patients have many questions as to understanding time-frame and extent of regeneration of the myelin. Many thanks!

  7. can you please tell if one works out regularly but only eats vegetarian food, no milk or curds , and no protein supplements, can it actually damage or affect the nerves ? specifically kegel nerves, pelvic nerves

  8. This is for studying neuroanatomy and healing. This is only a small part of medicine (7 minutes of 8 years, not including all of the years applying the basic studies to clinical cases). Specific problems should be managed by medical professionals. Thank you for your kindness in making these videos.

  9. I'm wondering if any medical professional can help me?

    I recently suffered a MDMA drug overdose and was admitted to hospital for kidney failure. Ever since then (it's been 19 days now), I've felt a significant decline in basic cognitive abilities such as memory, articulation of words and sentences, difficulty concentrating when others are speaking, as well as increased anxiety and depression.

    Can a sudden overload of serotonin cause Axonotmesis, and if so, can the damaged axons repair themselves given the right conditions and nutritional support?

    Any advice on what I should do to get better would be very much appreciated.

    Thank you.

  10. Hello, my dad had a tumor pressing against his optic nerve. The tumor has been removed, however the optic nerve has been damaged causing him to lose about 80% of his vision. Is there any hope in the optic nerve regenerating. It has been 2 years since the tumor has been removed. Any info you could provide would be helpful. Thank you.

  11. Thanks for your sharing your knowledge and information! But… What if I went to a chiropractor that mashed on one of the dents on my back where the sciatic nerve exits the hip and the next morning I woke up at 4:00 AM and my the muscles in my right leg were jumping and jerking and it felt like it felt a thousand volts of electricity was going down my right leg! Also I tiptoed on that foot for 1yr and 7 mths while visiting doctors and getting no help or relief because they wouldn't acknowledge what had been done to me! Then finally against my better judgement and as scared as I was I went back to see the chiropractor that did this to me to find out that he had entrapped my sciatic nerve and it had remained that way for 4 yrs… what are my chances of recovering? It's been 8 mths since I got the nerve unentrapped and I feel a little better but still ache badly! Thanks for any response!

  12. Hello I m fustated trying to find out if I ever wil be able to walk I have both of my legs nerve damage many MRI nerve test and I jus cant find any doctor to raoair my nerve ! If this doctor is real I wil like to go to see him!

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