Cholinesterase demonstration of dermal nerve endings in patients with impaired sensation

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Abstract
It would appear that the number of ChE-reacting Meissner corpuscles is a measure of peripheral nerve function and in our experience the results are highly reproducible. We have found ChE reactivity of these corpuscles to be absent in many patients with severe peripheral nerve lesions, while it is uniformly present in those with lesions of the central nervous system. Using only a small sample of skin, we have been able to show the decline in numbers of Meissner corpuscles that occurs with advancing age. Unlike biopsy of the nerve trunk, the technic of dermal punch biopsy does not bear the hazard of permanent sequelae and can be carried out in the office. This preliminary study would suggest that this technic may be an additional method of diagnosing, classifying, and studying the peripheral neuropathies.