Clinical, Sonographic, and Electrophysiologic Longitudinal Features of Chronic Inflammatory Demyelinating Polyneuropathy

Abstract

BACKGROUND AND PURPOSE Several studies have aimed to find potential biomarkers to simplify the diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) and to monitor and predict the disease course. However, reliable markers are still lacking. We aimed to investigate whether high‐resolution nerve ultrasound (HRUS) is suitable for monitoring the long‐term clinical course of CIDP. METHODS Twenty patients fulfilling the definite diagnostic criteria of CIDP received clinical examination, evaluation of the INCAT (inflammatory neuropathy cause and treatment) overall disability sum score (ODSS) as well as nerve conduction studies, and HRUS every 6 months over a median follow‐up time of 34 months. Patients were divided into clinically stable/regressive disease course or progressive disease course according to the development of the ODSS. RESULTS The intranerve cross‐sectional‐area (CSA) variability of the nerves of the lower extremity increased with disease progression, whereas it remained unchanged in patients with a stable or remitting disease course. CONCLUSION Nerve ultrasound can be used as a method to objectify the long‐term disease course in CIDP patients. The intranerve CSA variability is suitable for monitoring the clinical course of patients with CIDP.

Serial nerve ultrasound and motor nerve conduction studies in chronic inflammatory demyelinating polyradiculoneuropathy

“…Hartig et al showed that some patients developed progressive nerve enlargement despite clinical improvement or stabilization. Fisse et al showed that intranerve CSA variability of the tibial and fibular nerves but not the median and ulnar nerves increased with disease progression. Transverse images of the median and ulnar nerves were obtained at only 2 locations in these studies.…”

Comprehensive approaches for diagnosis, monitoring and treatment of chronic inflammatory demyelinating polyneuropathy

“…However, nerve conduction studies cannot reproduce clinical dynamics, i.e. due to severe secondary axonal damage [23]. Studies on use of electromyography for disease monitoring are lacking.…”

“…In disease course, increase or decrease of CSA enlargement, i.e. measured by intra-nerve CSA variability, can provide information about disease activity and response to therapy [23,41].…”

Guidelines for neuromuscular ultrasound training

“…Over the years, it has evolved into a distinct ultrasound subspecialty. A vast amount of literature provides evidence regarding the value of neuromuscular ultrasound in the diagnostic evaluation of neuromuscular disorders (more key references are provided in Data S1 online) . As a result, neuromuscular ultrasound has become a fundamental diagnostic tool in many electrodiagnostic labs, clinics, and radiology centers.…”

“…vided in Data S1 online). [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] As a result, neuromuscular ultrasound has become a fundamental diagnostic tool in many electrodiagnostic labs, clinics, and radiology centers. This has driven a growing interest among physicians to learn and master the skill.…”