Overview
The Peripheral Nerve Program at Westchester Medical Center offers multidisciplinary subspecialty care for patients with injuries or conditions affecting the nerves of the body outside of the brain and spinal cord.
Traumatic Nerve Injuries
A major focus is the treatment of injured nerves after trauma. For nerves that are injured and form a painful and disorganized collection of neural tissue called a neuroma, the neuroma may be removed followed by placement of a bridge to span the gap (called a nerve graft), which can help with pain control. For nerve injuries that do not recover after three to six months, surgery may be recommended for freeing up scar tissue around the injured nerve (called an external neurolysis) and to encourage recovery. In other cases, an injured part of the nerve may be removed and replaced with a nerve from elsewhere in the body (called a nerve graft). Finally, a third option is to take part of a nearby working nerve and hook it directly into a non-working nerve to restore function (called a nerve transfer).
For nerves that are injured sharply, such as by a knife, surgery to sew the nerves back together is commonly undertaken within the first 48 hours. We treat patients of all ages with nerve injuries, including infants who are born with injury to the nerves of the upper extremity, such as Erb’s palsy. Learn more about our Pediatric Peripheral Nerve Program.
Arm/Hand Weakness after Spinal Cord Injury
Spinal cord injury is a life-changing event. Although surgeons are not yet able to directly repair certain injuries to the spine itself, there are surgical techniques called nerve transfers that can be used to help restore certain functions in select cases of spinal cord injury. In these procedures, working nerves above the level of spinal cord injury can be rewired to serve muscles that are otherwise served by non-working nerves. Depending on the specific pattern of injury, goals of surgery include restoring elbow movement and the ability to pinch, grasp, and open fingers of the hand. The same techniques can be used in pediatric patients suffering from weakness after conditions that affect the spinal cord such as acute disseminated encephalomyelitis or other demyelinating disorders.
Tumors of the Peripheral Nerves
In addition to the treatment of traumatic injuries, we also provide comprehensive care for patients with tumors of the peripheral nerves. If nerves are thought of as electric wires, the insulation around the wire can sometimes give rise to a growth called a nerve sheath tumor. Other times, a growth may arise from the nerve itself.
We treat all tumor types located in peripheral nerves, such as schwannomas, neurofibromas, malignant peripheral nerve sheath tumors, and perineuriomas, or in the networks of nerves serving the arms and legs: the brachial plexus and lumbar plexus.
Our providers enjoy a strong relationship with Adult Neuro-Oncology and Pediatric Neuro-Oncology Programs, which offer specific expertise in patients with Neurofibromatosis types 1 and 2.
Nerve Compression and Entrapment Syndromes
Finally, we treat patients with nerves of the arms and legs that are compressed (called entrapment syndromes). Common entrapments include carpal tunnel syndrome (median nerve compression at the wrist), cubital tunnel syndrome (ulnar nerve compression at the elbow), thoracic outlet syndrome, and common peroneal nerve entrapment at the leg. We also treat headache conditions such as occipital neuralgia by offering treatments that range from occipital nerve decompression to C2 ganglionectomy.
We rely on heavy collaboration with our Neurology colleagues and their specialized expertise in electrodiagnostic studies such as electromyography (EMG) and nerve conduction studies (NCS).
Our anesthesia and pain management colleagues provide interventions to treat painful conditions such as complex regional pain syndrome (CRPS), previously referred to as reflex sympathetic dystrophy (RSD). Interventions range from local injections to implantation of peripheral nerve stimulators for pain control.
Our neuroradiology colleagues offer advancing magnetic resonance imaging of the nerves, including the brachial plexus, and ultrasound images which can help to guide interventions for a specific patient. Our colleagues in plastic surgery offer expertise in hand surgery (Ke Nan Huang, MD) and facial nerve reanimation (Elizabeth Zellner, MD).
Conditions We Treat
Peripheral nerve surgeons at Westchester Medical Center treat a wide range of conditions, including the following.
- Brachial plexus injury
- Birth-related (obstetric) brachial plexus injury
- Erb’s palsy
- Klumpke palsy
- Thoracic outlet syndrome
- Tarsal tunnel syndrome
- Carpal tunnel syndrome
- Cubital tunnel syndrome
- Complex regional pain syndrome
- (Morton) Neuroma
- Meralgia Paresthetica
- Sciatic nerve injury
- Peroneal nerve entrapment
- Laceration or blunt nerve injury
- Schwannoma
- Neurofibroma
- Perineurioma
- Malignant peripheral nerve sheath tumor (MPNST)
- Neurofibromatosis type 1
- Neurofibromatosis type 2
- Upper extremity weakness after spinal cord injury
- Brachial plexus tumor
- Occipital neuralgia
- Nerve root avulsions
4th Floor, Ambulatory Care Pavilion
100 Woods Road
Valhalla, NY 10595
Phone: 914.493.2363
Fax: 914.493.2505