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Neuropathology

Neuropathology is the study of disease of nervous system tissue, usually in the form of either small surgical biopsies or whole-body autopsies. Neuropathologists usually work in a department of anatomic pathology, but work closely with the clinical disciplines of neurology, and neurosurgery, which often depend on neuropathology for a diagnosis. Neuropathology also relates to forensic pathology because brain disease or brain injury can be related to cause of death.

Neuropathology should not be confused with neuropathy, which refers to disorders of the nerves themselves (usually in the peripheral nervous system). The work of the neuropathologist consists largely of examining biopsy tissue from the brain and spinal cord to aid in diagnosis of disease. The biopsy is usually requested after a mass is detected by radiologic imaging, the imaging in turn driven by presenting signs and symptoms of a patient. As for autopsies, the principal work of the neuropathologist is to help in the post-mortem diagnosis of various forms of dementia and other conditions that affect the central nervous system.

Biopsies can also consist of the skin. Epidermal nerve fiber density testing (ENFD) is a more recently developed neuropathology test in which a punch skin biopsy is taken to identify small fiber neuropathies by analyzing the nerve fibers of the skin. This pathology test is becoming available in select labs as well as many universities; it replaces the traditional sural nerve biopsy test as less invasive. It is used to identify painful small fiber neuropathies.