New teased-fibre definitions represent specific mechanisms of neuropathy

Although nerve biopsy is a classical approach, it still plays a role in the diagnosis and elucidation of the pathophysiology of neuropathy.1 There are two major techniques used to assess the morphology of nerve fibres in the longitudinal direction; one involves cutting glutaraldehyde-fixed epoxy-resin-embedded specimens into longitudinal sections and the other involves teasing the nerve fibres. Longitudinal sections are suitable for fine structural assessments using transmission electron microscopy to demonstrate, for example, paranodal pathology in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) displaying anti-neurofascin 155 antibodies.2 However, longitudinal sections are not useful for viewing complete pictures of long lesions that extend over several nodes of Ranvier. Conversely, teased-fibre preparations enable observations of long nerve fibre …