Ultrasonographic appearance of nerve roots in patients with guillain-barre syndrome (GBS): Comparison between acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor axonal neuropathy (AMAN)

Iizuka, Natsuko; Nomoto, Shohei; Kurokawa, Shinji; Kasai, Harubumi; Itaya, Kazuhiro; Ichikawa, Hiroo

doi:10.1016/j.jns.2017.08.3592

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“…In acute motor axonal neuropathy/acute motor and sensory axonal neuropathy (AMAN/AMSAN), primary axonal degeneration with a paucity of inflammatory lymphocytic infiltration is the main pathology finding, and edema is less frequently reported (25,30). One sonographic study showed that the nerve root width was significantly larger in an AIDP group than in patients with AMAN and unclassified conditions (14), which also supported the nerve edema should be related to the nerve enlargement.…”

Section: Discussionmentioning

confidence: 98%

“…Recently, morphological studies using sonography have become a popular tool in addition to the classic electrophysiological studies in clinical practice. Nerve enlargement could be clearly seen in entrapment neuropathy with sonography by an experienced operator, but there are few sonography studies on GBS ( 12 – 14 ); those on MFS are even rarer ( 15 ). The facial nerve has been investigated by sonography in patients with Bell's palsy ( 16 – 19 ), however, the use of facial nerve sonography has not been explored in MFS before.…”

Section: Introductionmentioning

confidence: 99%

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A Pilot Study on Serial Nerve Ultrasound in Miller Fisher Syndrome

et al. 2020

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Objective: Miller Fisher syndrome (MFS) is predominantly a clinical diagnosis, with classic triad of ophthalmoplegia, ataxia, and generalized reduced reflexes. Previous studies in chronic and acute immune-mediated neuropathies indicated that ultrasound, may help to detect changes that could correspond with disease activity. We studied the feasibility of serial nerve ultrasound in MFS, using a healthy controls. Methods: All MFS patients (n = 5) and healthy controls (n = 18), underwent a standardized sonographic protocol that evaluated nerve sizes of facial, large arm and leg nerves, and spinal nerve roots. All MFS patients underwent routine ancillary investigations, including electrodiagnostic testing and for presence of anti-GQ1b antibodies. In addition, four MFS patients had 2nd, and 3rd clinical and sonographic evaluation at 14 and 90 days from onset. Results: The width of the facial nerve was significantly larger in the MFS group than in the control group (MFS: 1.19 ± 0.31 mm vs. normal: 0.67 ± 0.13 mm, P = 0.01). The size of the cervical roots and the nerves in the limbs were similar between the two groups. Two patients' facial nerve size subsided with time, but the decrease in other nerves' sizes were not obvious. Conclusion: Our study showed that serial nerve ultrasound studies are feasible in MFS, and can capture changes in facial nerve size that could complement routine diagnostic tests. Further studies are warranted to determine and compare its test characteristics in MFS.

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Section: Discussionmentioning

confidence: 98%