Neuromuscular ultrasound findings in distal acquired demyelinating symmetric variant of chronic inflammatory demyelinating polyneuropathy

Vu, Quang; Cartwright, Michael S.

doi:10.1002/mus.25739

Cited by 7 publications

(8 citation statements)

References 10 publications

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“…Nerve enlargements in multifocal CIDP (also known as MADSAM or Lewis Sumner syndrome) found not only in the clinically and electrophysiologically affected nerves, for example, at sites with conduction blocks but also in clinically asymptomatic nerves [38]. Nerve enlargements in distal CIDP (also known as DADS) are similar to that of typical CIDP but with less pronounced enlargement and less involvement of the nerve roots [39,40]. In paranodopathies, case reports describe partially not only slightly enlarged nerve sections but also enlarged nerves at typical compression sites, but the studies are still insufficient to make a diagnostic recommendation for paranodopathies [41].…”

Section: Andandmentioning

confidence: 99%

Nerve ultrasound for the diagnosis and follow-up of peripheral neuropathies

Pitarokoili

Gold

Fisse

2023

Current Opinion in Neurology

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Purpose of reviewThe purpose if this review is to provide an overview of the available data on the use of nerve ultrasound for the diagnosis and follow-up of peripheral neuropathies. Recent findingsDuring the last decade, nerve ultrasound has been established as a complementary tool for the evaluation of morphological changes mostly for immune-mediated polyneuropathies. Through the development of ultrasound protocols for evaluation of disease-specific sites, nerve ultrasound has proven to be a practical, widely available, reproducible diagnostic tool with no relevant contraindications.

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Section: Andandmentioning

confidence: 99%

Nerve ultrasound for the diagnosis and follow-up of peripheral neuropathies

Pitarokoili

Gold

Fisse

2023

Current Opinion in Neurology

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“…Vu et al. reported profound multifocal nerve enlargement in a man with DADS 11 . Both Scheidl et al 12 .…”

Section: Discussionmentioning

confidence: 99%

“…10 Few studies have investigated the peripheral nerve morphologic features of different clinical subtypes, except for case reports using ultrasound or MRI. [11][12][13][14][15] MRI can show cervical roots and proximal nerve trunks but usually not distal nerve trunks. Most nerve ultrasound studies have observed only three to five sites in the upper limb nerve.…”

Section: Introductionmentioning

confidence: 99%

“…A previous electrophysiological study showed preferential involvement of distal and proximal segments in typical CIDP, where the blood‐nerve barrier is deficient 10 . Few studies have investigated the peripheral nerve morphologic features of different clinical subtypes, except for case reports using ultrasound or MRI 11–15 . MRI can show cervical roots and proximal nerve trunks but usually not distal nerve trunks.…”

Section: Introductionmentioning

confidence: 99%

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The distribution pattern of nerve enlargement in clinical subtypes of chronic inflammatory demyelinating polyneuropathy

Niu,

Zhang,

et al. 2023

Journal of Neuroimaging

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Background and PurposeWe aim to investigate nerve enlargement patterns and their correlation with clinical subtypes and treatment response using nerve ultrasound in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).MethodsBetween March 2015 and December 2021, 135 CIDP patients were recruited. Nerve ultrasound and electrophysiological studies were performed on the median and ulnar nerves. The responses to intravenous immunoglobulin (IVIg) or prednisone were evaluated with the disability score.ResultsThere were 99 typical CIDP cases, 10 Lewis‐Sumner syndrome (LSS) cases, 15 distal acquired demyelinating symmetric neuropathy (DADS) cases, nine pure motor CIDP cases, and two pure sensory CIDP cases. Sixty (61%) typical CIDP and seven (78%) pure motor CIDP patients had moderately increased or normal cross‐sectional area (CSA), and 10 (67%) DADS and seven (70%) LSS patients had significantly increased CSA. The peripheral nerve showed a diffuse enlargement pattern in 46 (51%) typical CIDP, five (50%) LSS, three (25%) DADS, and three (33%) pure motor CIDP patients and a proximal regional enlargement pattern in 11 (12%) typical CIDP, one (10%) LSS, six (50%) DADS, and four (44%) pure motor CIDP patients. Patients with diffusely moderate enlargement patterns and those with proximal regional enlargement showed a higher response rate to glucocorticoids than to IVIg.ConclusionsVarious distribution patterns of nerve enlargement existed in CIDP. Although almost all patterns could be detected in each CIDP subtype, diffusely moderate enlargement was more common in typical CIDP and LSS, while proximal regional enlargement was more common in DADS and pure motor CIDP. Different enlargement patterns might indicate different treatment responses.

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“…Literature data regarding US in d-CIDP is scarce, due probably to two factors: rstly, most studies did not differentiate between subtypes or only included typical CIDP, and secondly a more de nite de nition was only recently made 1 . One report highlights diffuse n-CSA enlargement, especially in the distal sensory segments 23 . As far as our results are concerned, the fact that the n-CSA was not increased is not particularly surprising.…”

Section: Discussionmentioning

confidence: 99%

Typical CIDP, distal variant CIDP, and anti-MAG antibody neuropathy – an ultra-high frequency ultrasound comparison of nerve structure

Puma,

Grecu,

Badea

et al. 2023

Preprint

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To date, little is known about the usefulness of ultra-high frequency ultrasound (UHF-US, 50–70 MHz) in clinical practice for the diagnosis of dysimmune neuropathies. We present a prospective study aimed at comparing UHF-US alterations of nerves and fascicles in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), distal CIDP (d-CIDP) and anti-MAG neuropathy and their relationships with clinical and electrodiagnostic (EDX) features. Twenty-eight patients were included (twelve CIDP, six d-CIDP and ten anti-MAG) as well as ten healthy controls. Each patient underwent neurological examination, EDX and UHF-US study of both median and ulnar nerves. UHF-US was reliable in differentiating immune neuropathies from controls when using mean and/or segmental nerve and/or fascicle cross-sectional area (CSA); furthermore, fascicle ratio (fascicle/nerve CSA, FR) was a reliable factor for differentiating d-CIDP from other types of polyneuropathies. Mean median nerve fascicle CSA, fascicle CSA and FR for the median nerve in the antecubital fossa and for the ulnar nerve in the midarm segment were able to distinguish CIDP from anti-MAG polyneuropathy, while ulnar nerve CSA in the mid-forearm differentiated between anti-MAG and d-CIDP. UHF-US offers information beyond simple nerve CSA and allows for a better characterization of the different forms of dysimmune neuropathies.

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Neuromuscular ultrasound findings in distal acquired demyelinating symmetric variant of chronic inflammatory demyelinating polyneuropathy

Cited by 7 publications

References 10 publications

Nerve ultrasound for the diagnosis and follow-up of peripheral neuropathies

Nerve ultrasound for the diagnosis and follow-up of peripheral neuropathies

The distribution pattern of nerve enlargement in clinical subtypes of chronic inflammatory demyelinating polyneuropathy

Typical CIDP, distal variant CIDP, and anti-MAG antibody neuropathy – an ultra-high frequency ultrasound comparison of nerve structure

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