The peripheral nervous system also carries all the motor information from your brain and spinal cord back to the muscles of your body.  This information can be voluntary (you decide you want to move a muscle and you move it) or involuntary (breathing, sweating, digesting, etc.). 

The nervous system is divided into a central portion (brain and spinal cord) and a peripheral portion (all the nerves once they exit the brain and spinal cord).  The peripheral nervous system carries all the sensory information from your body back to the spinal cord and brain. This sensory information can be the feeling of touch, the feeling of pain, the feeling of pressure, the feeling of hot or cold, and the feeling of knowing where your body parts are in space without looking at them.

Diagnosis

The most important diagnosis in the evaluation of peripheral nerve problems is electromyography (EMG) with nerve conduction studies (NCS) which provides an accurate and a quantitative information on the function of nerves and muscles and also helps to precisely localize the region of injury.

Causes

• Numbness, tingling and burning pain are caused by dysfunction of the nerve and can be caused by one or several of the following reasons:
• Demyelination of the nerve sheath: the insulating material around the nerve can break down as in multiple sclerosis, Charcot-Marie-Tooth or CMT, and vitamin B6 or 12 deficiencies
• Vasculitis or inflammation of the blood vessels in the nerve sheath causing lack of blood supply or oxygen delivery to the nerve, as in rheumatoid arthritis and scleroderma
• Compression of the nerve in the neck or back: a herniated disc, most commonly, in the neck or back or spinal stenosis can interfere with nerve impulses traveling down the spinal cord and cause weakness and numbness
• Trauma to the nerve from an accident in a car or at work or from another surgery can cause the nerve to get caught in scar tissue, or be simply cut or crushed

Compression of the nerve in the arms and legs occurs where the nerve travels through an area that is narrowed. Swelling of the nerve from diabetes, chemotherapy or repetitive trauma can cause the nerve to swell and get stuck in this area of narrowing. This will cause a lack of blood supply to the nerve and eventually will cause this area of the nerve to die.

Diagnosis

Prior to surgery or other treatment, each patient has to be diagnosed with techniques that may include:

• EMG and nerve conduction studies
• MRI-an imaging technique used when the physician suspects peripheral nerve tumors, traumatic injury, post-irradiation neuritis, chronic compression, and some pain syndromes.

Possible surgeries for treatment may include:

• Internal and external neurolysis for the management of scars,
• Surgical revision of painful neuromas
• Excision of nerve sheath tumors
• Surgical exploration of complex or scarred nerve injuries
• Nerve grafting for repair

The other Neurology Procedures are:

• Brachial Plexus Surgery
  
• Brain Surgery
  
• Carotid Artery Surgery / Endarterectomy … etc

Few Major Hospitals for Peripheral Nerve Surgery are:

• Wockhardt Hospitals
  
• Apollo Hospitals
  
• Max Healthcare
  
• Piyavate Hospital
  
• Florence Nightingale Hospital
  

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