Ultrasound in the diagnosis of peripheral neuropathy: structure meets function in the neuromuscular clinic

Gallardo, Elena; Noto, Yu‐ichi; Simon, Neil

doi:10.1136/jnnp-2014-309599

Cited by 108 publications

(94 citation statements)

References 79 publications

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“…Typical CIDP is associated with variability of ultrasound findings, and this may relate to the stage of the disease [3]. US of normal nerve demonstrates hypoechoic fascicles surrounded by hyperechoic perineurial connective tissue and epineurium [3].…”

Section: Discussionmentioning

confidence: 99%

“…Nerve ultrasound is emerging as a possible additional diagnostic tool in the work-up of patients with peripheral neuropathy, in particular those patients with suspected inflammatory neuropathy [3]. However, there are few reports of the ultrasound findings in MADSAM neuropathy [4], and the correlation between ultrasound, clinical and electrodiagnostic findings in typical CIDP remain incompletely elucidated.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Precise correlation between structural and electrophysiological disturbances in MADSAM neuropathy

Simon

Kiernan

2015

Neuromuscular Disorders

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Precise correlation between structural and electrophysiological disturbances in MADSAM neuropathy

Simon

Kiernan

2015

Neuromuscular Disorders

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“…The value of nerve ultrasonography (NUS) in immune-mediated polyneuropathies is well described (Beekman et al, 2005;Gallardo et al, 2015;Grimm et al, 2014a,b,c;Hobson-Webb and Cartwright, 2014;Kerasnoudis et al, 2013Kerasnoudis et al, , 2014aPadua et al, 2012Padua et al, , 2014Scheidl et al, 2012Scheidl et al, , 2014Zaidman et al, 2009Zaidman et al, , 2013Zaidman et al, , 2014.…”

Section: Introductionmentioning

confidence: 97%

Ultrasound and electrophysiologic findings in patients with Guillain–Barré syndrome at disease onset and over a period of six months

Grimm

Décard

Schramm

et al. 2016

Clinical Neurophysiology

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“…Assessment of intraneural vascular flow is based on Doppler and power Doppler techniques (the latter being particularly effective to show small vessel flow), which enable depiction of the nerve circulatory system 26 . In healthy nerves, vascularization cannot be detected, whereas increased intraneural vascularization can be seen in entrapment 27 , inflammatory neuro pathies 22 and neurolymphomatosis 28 . The clinical value of intraneural vascular flow is currently under debate.…”

Section: Ultrasonographymentioning

confidence: 99%

“…The high spatial resolution of ultrasonographic imaging -currently below 1 mm -enables detailed imaging of nerve morphology (including fascicles, epineurium, perineurium and echotexture) and size, and of the surrounding structures, such as muscles, soft tissues and vessels 21 . Such imaging can provide accurate evaluation of small nerves, such as the digital nerves 22 .…”

Section: Ultrasonographymentioning

confidence: 99%

New technologies for the assessment of neuropathies

et al. 2017

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Peripheral neuropathies are among the most common neurological disorders 1 . In routine clinical practice, diagnosis of peripheral neuropathies is typically based on clinical assessment, nerve conduction studies and needle electromyography, which can determine whether symptoms are caused by primary axonal damage or demyelinating damage. This distinction is often relevant to therapeutic choices and to prognosis, as axonal damage typically reflects an inflammatory (for example, vasculitic) or degenerative (for example, hereditary or idiopathic) process that correlates with disability, whereas demyelinating damage can reflect a hereditary neuro pathy, but more often reflects an acquired immunemediated neuropathy. Besides metabolic, inflammatory or primary degenerative neuropathies, peripheral nerves can also be damaged by compression from adjacent tissue structures, such as tendons, cysts or haematomas. In this case, proper identification of the site, nature and degree of the lesion might be challenging, but is relevant to treatment and prognosis. Moreover, some patients present with symptoms that suggest damage to small nerve fibres, which nerve conduction studies cannot be used to detect.In the past 15 years, several techniques have become available to investigate focal and diffuse peripheral neuropathies, and their reliability has widened the spectrum of diagnostic tools for clinicians and improved assessment of neuropathies. In this Review, we provide an overview of these new and emerging technologies. We first discuss peripheral nerve imaging with MRI and ultrasonography, which can provide information about the precise localization of neuro pathies and the pathological processes involved in large-fibre neuropathies, and can complement clinical and electrophysiological evaluation. We then consider techniques that can provide diagnostic information when the pathological process is restricted to small nerve fibres and is consequently not detectable with nerve conduction studies or neuroimaging. These include skin biopsy, which is established in clinical practice, and the emerging techniques of corneal confocal microscopy, laser-evoked potentials and heat-related and pain-related evoked potentials, and microneurography.Nerve imaging technology Advances in imaging techniques have made it possible to gain great insight into nerve pathology with magnetic resonance and ultrasound. Each approach offers distinct advantages, and can provide different information about damage to large myelinated fibres. Abstract | Technical advances are rapidly changing the clinical and instrumental approach to peripheral nerve diseases. Magnetic resonance neurography, diffusion tensor imaging and nerve ultrasonography are increasingly entering the diagnostic workup of peripheral neuropathies as tools that complement neurophysiology and enable investigation of proximal structures, such as plexuses and roots. Progress in the design of magnetic resonance scanners and sequences, and the development of high-frequency ultrasound probes mean th...

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Ultrasound in the diagnosis of peripheral neuropathy: structure meets function in the neuromuscular clinic

Cited by 108 publications

References 79 publications

Precise correlation between structural and electrophysiological disturbances in MADSAM neuropathy

Precise correlation between structural and electrophysiological disturbances in MADSAM neuropathy

Ultrasound and electrophysiologic findings in patients with Guillain–Barré syndrome at disease onset and over a period of six months

New technologies for the assessment of neuropathies

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