Precise correlation between structural and electrophysiological disturbances in MADSAM neuropathy

A comparative study of brachial plexus sonography and magnetic resonance imaging in chronic inflammatory demyelinating neuropathy and multifocal motor neuropathy

“…These brachial plexus abnormalities did not aid in further differentiating between CIDP and MMN. The exact pathological or electrophysiological correlates of imaging abnormalities are largely unknown and require further study . In contrast to some previous studies that included patients with longer disease duration , we found no gadolinium contrast enhancement.…”

Nerve ultrasound in polyneuropathies

“…48,49 One study has suggested that the nerve enlargement in CIDP may reflect underling axonal damage/loss and may not be seen in purely demyelinating lesions, 39 while others have described nerve enlargement at sites of conduction block. [50][51][52] There appears to be little association between nerve size and the distal compound motor action potential 35,36,38,47,48 or degree of weakness or disability. 10,36,39,41,42,47 Nerve size in CIDP may vary with disease duration and treatment.…”

“…Most studies have found a relationship between larger nerve size and slower motor conduction velocity though some others did not . One study has suggested that the nerve enlargement in CIDP may reflect underling axonal damage/loss and may not be seen in purely demyelinating lesions, while others have described nerve enlargement at sites of conduction block . There appears to be little association between nerve size and the distal compound motor action potential or degree of weakness or disability …”

Normalization of sonographical multifocal nerve enlargements in a MADSAM patient following a good clinical response to intravenous immunoglobulin

“…Nerves were classified as being enlarged when their CSAs exceeded the Page 4 of 16 5 reference intervals of our institution (95% confidence intervals of 45 healthy controls) [6]. Sonographical "inching" studies were performed at nerve segments corresponding to the locations of the SSNCS [3,7]. Written informed consent was obtained from the patient.…”

“…Regarding multifocal acquired demyelinating sensory and motor neuropathy (MADSAM), a limited number of papers described sonographical visualization of multifocal enlargements and abnormal echo-texture of the peripheral nerves at sites of conduction blocks [2][3][4] patient following functional recovery with treatment [2]; data showed that focal enlargements and a change in the echo-texture of nerves persisted after clinical and electrophysiological remission [2]. In contrast to this earlier paper, here we present the case of a MADSAM patient whose sonographical multifocal nerve enlargements normalized following a good clinical and electrophysiological response to treatment.…”