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

Muscle Nerve. 2019 Sep;60(3):254-262. doi: 10.1002/mus.26611. Epub 2019 Jul 1.

Abstract

Introduction: The objective of this study was to evaluate the correlation between cross-sectional area (CSA) and nerve conduction studies (NCS) in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and to determine how CSA changes over time after standard treatment.

Methods: Fifty-four patients with CIDP were recruited prospectively, and 21 patients were followed for more than 6 months. Ultrasonography and motor NCS were performed in the median and ulnar nerves.

Results: No or weak correlation was observed between the maximum CSA and motor conduction velocity. There were segmental nerve enlargements at 61% of sites with conduction block or temporal dispersion. Among 19 patients with clinical improvement after immunotherapy, CSA decreased to normal in 5, increased in 10, and were unchanged in 4.

Discussion: Different patterns of CSA and motor NCS changes after immune treatment may indicate different CIDP pathologic mechanisms. Exploration of these pathologic mechanisms could guide treatment choices in the future. Muscle Nerve, 2019.

Keywords: chronic inflammatory demyelinating polyradiculoneuropathy; cross-sectional area; electromyography; follow-up; motor conduction velocity; ultrasonography.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Diagnosis, Differential
  • Female
  • Humans
  • Inflammation / physiopathology*
  • Male
  • Middle Aged
  • Nerve Tissue / physiopathology
  • Neural Conduction / physiology*
  • Neurologic Examination / methods
  • Peripheral Nerves / diagnostic imaging
  • Peripheral Nerves / physiology
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / diagnosis
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / physiopathology*
  • Ultrasonography* / methods
  • Young Adult