Sonographic detection of diffuse peripheral nerve hypertrophy in chronic inflammatory demyelinating polyradiculoneuropathy

Abstract

Chronic inflammatory demyelinating polyradiculoneuropathy is an autoimmune disease characterized by recurrent demyelination and remyelination with resultant thickening of the peripheral nerves. We report a case in which sonography was instrumental in demonstrating diffuse peripheral nerve hypertrophy. On sonography, both brachial plexuses were found to be diffusely hypertrophic and hypoechoic. Similar findings were noted for the median, sciatic, and femoral nerves. The brachial plexus findings were confirmed by MRI.

Detection of cervical nerve root hypertrophy by ultrasonography in chronic inflammatory demyelinating polyradiculoneuropathy

“…US in case 2 demonstrated marked hypertrophy of the cervical nerve roots, which is consistent with the findings of MRI. Since there have been only two cases, our case 2 and a case reported by Taniguchi et al [24], in which both MRI and US of cervical nerve roots were performed, further studies in which results of US and MRI in equal numbers of CIDP patients are compared should be performed to determine the association between US and MRI findings and the accuracy of each method.…”

“…Attempts have been made in some recent studies to evaluate the peripheral nerves of extremities by US in patients with hereditary motor and sensory neuropathy type 1 [16,23], in which widespread hypertrophy of peripheral nerves, including nerve roots, can occur as well as CIDP. In contrast to the frequent use of US for evaluating these diseases, however, there has been only one case report on US findings of peripheral nerves and nerve roots in CIDP [24]. The purpose of this study was to determine whether US enables detection of hypertrophy of the cervical nerve roots in CIDP patients, how frequently nerve root hypertrophy occurs in CIDP, and whether US findings correlate with any clinical or laboratory features.…”

Comparison of clinical, electrophysiological, sonographic and MRI features in CIDP

“…In order to dissect morphological abnormalities of the peripheral nerves, different imaging techniques, such as nerve ultrasound and MRI, were introduced. MRI techniques were the first to show the distinctive pattern of peripheral nerve hypertrophy [4][5][6][7] and nerve ultrasound followed as a practical, affordable and effective method to detect morphological nerve alterations in different forms of peripheral neuropathy [8][9][10][11]. However, the pathophysiological background and the diagnostic and prognostic value of these morphological nerve alterations still remain unclear.…”

Nervenultraschall bei Polyneuropathie – sinnvoll oder nicht?

“…In den letzten Jahren haben sich einige Arbeitsgruppen mit den Verände-rungen bei CIDP [19,22,24,25,32,33,35,48,51], bei GBS [1,27], aber auch bei MADSAM [43] und MMN [2,12] beschäftigt. Auch seltenere Neuropathien wie die POEMS-assoziierte PNP wurden beschrieben [30].…”