The peripheral nerves include all of the nervous system connections outside of the brain and spinal cord. They control sensation, movement and autonomic functioning of all organs, muscles and sensations. Abnormal growth of tissue in or around these peripheral nerves can disrupt the nerves in the area affected. This could cause difficulty walking or moving muscles, decreased sensation or pain. These abnormal growths are called peripheral nerve tumors and they are usually benign, not cancerous. The cause of these tumors is usually not known but there are genetic conditions or previous radiation therapy that can predispose you to them. A physical exam will indicate the injured nerves and imaging tests can further show the tumors. Treatment of peripheral nerve tumors usually involves surgery to remove them and protect the associated nerves and other structures of the body. Getting an accurate evaluation and appropriate care will help you get better as quickly as possible.
Symptoms will depend on the location and size of the peripheral nerve tumor. The tumor can directly affect the organs, muscles, other nerves and blood vessels around it. A tumor in the upper neck nerves can decrease shoulder function while lower neck nerve injury will affect the arm and hand. You may have a lump under the skin, muscle weakness, and pain or numbness. Loss of function from a peripheral nerve tumor can be permanent. When you notice an unknown lump or begin having difficulties performing your normal daily activities then it is time to see your doctor.
In most cases it may not be able to determine the cause of a peripheral nerve tumor. There are some genetic syndromes that will predispose you to tumor formation. Neurofibromatosis is one syndrome that runs in families where you can develop tumors throughout your body. If you have had radiation therapy you may have tumor formation years later. The appropriate diagnosis and management is especially important with this type of injury.
Your doctor will perform a complete history and physical exam to evaluate you for your source of your pain and discomfort. Your nerve function will be evaluated along with and muscle strength, reflexes and skin sensation. Imaging tests can help your doctor identify peripheral nerve tumors. A computed tomography (CT) scan uses the electromagnetic energy of X-rays to provide a detailed look at the bony anatomy and tissue around it. A magnetic resonance imaging (MRI) uses powerful magnets and radio waves to create a detailed picture of soft tissue of the muscles, soft tissue and nerves. Contrast dye may be used during both the CT scan and MRI to better evaluate the area of the tumor. Nerve conduction studies look for nerve damage by using electrodes to measure how quickly a nerve impulse is transmitted. An electromyogram uses needle electrodes to look for muscle damage. A Tumor Biopsy or Nerve Biopsy is a procedure that takes a piece of the tumor or nerve which can be evaluated for the type of cells to help direct tumor management.
Our neurosurgeons can evaluate your tumor and let you know all of your options for treatment. A small peripheral nerve tumor that is slow-growing or causes mild or no symptoms may just need to be watched. This would involve regularly scheduled visits with your physician as well as possible imaging studies at regular intervals.
You may require surgery to remove a peripheral nerve tumor. Using advanced magnification and surgical techniques your neurosurgeon will remove all of the tumor or as much of the tumor as possible while preserving as much of your natural tissue and nerve function as possible. In some cases, monitoring the nerves can add an additional level of protection. Stereotactic radiosurgery such as a Gamma knife, uses beams of focused radiation to destroy tumor tissue without incisions. Should the tumor be malignant, then an optimal management strategy is discussed with you including surgery, radiation therapy and chemotherapy. Occupational and physical therapy may be necessary to help you maximize function lost from nerve damage.
The Norelle Health neurosurgeons are highly trained and skilled in the diagnosis, management, and treatment of all peripheral nerve tumors. Our neurosurgeons can provide the optimal treatment. Neurosurgery is considered essential by insurances and should be covered with your plan. As out-of-network providers, we will check your benefits for you and let you know what they are so there are no surprises. We use an individualized treatment plan for your concerns to provide a personalized holistic plan of care. If you would like assistance, please feel free to contact us (link to contact page) or call our office (link to phone number).