Brain Centre Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Neurology and Clinical Neurophysiology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
Muscle Nerve. 2019 Oct;60(4):415-419. doi: 10.1002/mus.26629. Epub 2019 Jul 24.
We present a case series of six treatment-naive patients with clinical phenotypes compatible with chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy without electrodiagnostic features of demyelination but with abnormal peripheral ultrasound findings who responded to treatment.
All six patients underwent a complete set of ancillary investigations, including extensive nerve conduction studies. We also performed standardized nerve ultrasound of median nerves and brachial plexus as part of a larger effort to evaluate diagnostic value of sonography.
Nerve conduction studies did not show conduction block or other signs of demyelination in any of the six patients. Sonographic nerve enlargement was present in all patients and was most prominent in proximal segments of the median nerve and brachial plexus. Treatment with intravenous immunoglobulin resulted in objective clinical improvement.
Our study provides evidence that nerve ultrasound represents a useful complementary diagnostic tool for the identification of treatment-responsive inflammatory neuropathies.
我们报告了 6 例初治患者的病例系列，这些患者的临床表现与慢性炎症性脱髓鞘性多发性神经病和多灶性运动神经病相符，但电诊断无脱髓鞘特征，而外周超声检查结果异常，这些患者对治疗有反应。
所有 6 例患者均接受了一系列辅助检查，包括广泛的神经传导研究。我们还对正中神经和臂丛进行了标准化的神经超声检查，这是评估超声诊断价值的更大努力的一部分。
神经传导研究在这 6 例患者中均未显示传导阻滞或其他脱髓鞘迹象。超声检查发现所有患者均有神经增大，正中神经和臂丛近端最明显。静脉注射免疫球蛋白治疗后，患者的临床症状有客观改善。
我们的研究提供了证据，表明神经超声是一种有用的补充诊断工具，可用于识别对治疗有反应的炎性神经病。
