Department of Neurology, Kansai Electric Power Hospital, Japan.
Division of Clinical Neurology, Kansai Electric Power Medical Research Institute, Japan.
Intern Med. 2021 Sep 1;60(17):2867-2871. doi: 10.2169/internalmedicine.6782-20. Epub 2021 Mar 22.
Multifocal enlargements with the alteration of a normal fascicular pattern are considered to be sonographic peripheral nerve features in multifocal acquired demyelinating sensory and motor neuropathy (MADSAM), a subtype of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). We herein present the case of an 18-year-old patient with MADSAM in whom intensive sonological assessments revealed multifocal nerve enlargement within clinically affected cranial nerves. Our case demonstrated that, if systematically investigated with ultrasound, morphological changes similar to those in the peripheral nerves may be detected in a large proportion of clinically affected cranial nerves in MADSAM, boosting the future applications of cranial nerve ultrasound in CIDP.
多灶性肿大并伴有正常束状模式改变被认为是多灶获得性脱髓鞘感觉运动神经病(MADSAM)的超声周围神经特征,MADSAM 是慢性炎症性脱髓鞘多发性神经病(CIDP)的一个亚型。本文报告了一例 18 岁 MADSAM 患者,其强化超声评估显示临床受累颅神经内多灶性神经肿大。我们的病例表明,如果系统地进行超声检查,MADSAM 中很大一部分临床受累颅神经可能会出现类似周围神经的形态变化,这将推动颅神经超声在 CIDP 中的未来应用。