Exploring Ultrasonographic Atypical Aspects in Drug‐Resistant Multifocal Chronic Inflammatory Demyelinating Polyneuropathy

Exploring Ultrasonographic Atypical Aspects in Drug‐Resistant Multifocal Chronic Inflammatory Demyelinating Polyneuropathy

ABSTRACT Introduction/aims Chronic inflammatory demyelinating polyneuropathy (CIDP) and its variants are characterized by nerve enlargement (NE), particularly in the proximal segments of the median nerve (MN) and cervical roots, as assessed by ultrasound (US). NE is typically moderate and seldom exc...

Full description

Saved in:
Bibliographic Details
Main Authors: Angela Puma, Aurora Parrotta, Nicolas Azulay, Andra Ezaru, Michele Cavalli, Mihai Ioncea, Luisa Villa, Nicolae Grecu, Giulia Tammam, Sabrina Sacconi, Simona Maccora, Charles Raffaelli
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Brain and Behavior
Subjects:
echogenicity
fascicle
multifocal‐CIDP
nerve‐CSA
ultrasound
Online Access:https://doi.org/10.1002/brb3.70690
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:ABSTRACT Introduction/aims Chronic inflammatory demyelinating polyneuropathy (CIDP) and its variants are characterized by nerve enlargement (NE), particularly in the proximal segments of the median nerve (MN) and cervical roots, as assessed by ultrasound (US). NE is typically moderate and seldom exceeds double the normal size of the cross‐sectional area (CSA). Furthermore, limited knowledge exists regarding the changes in the internal structure of nerves evaluated with high‐frequency ultrasound. This study describes three cases of significant CIDP‐NE assessed with an ultra‐high‐frequency probe (UHF‐US; 33 MHz) showing how changes in US‐nerve images may guide treatment choice. Methods Three patients diagnosed with multifocal CIDP and followed for several years in our department were studied. Clinical evaluations, electrodiagnostic studies (EDX), laboratory analyses, and UHF‐US of the nerves were performed. Results Nerve conduction studies (NCS) revealed severe demyelinating neuropathy with conduction blocks, reduced motor conduction velocities (MCV) in all cases, and secondary axonal degeneration in two cases. Ultrasound showed NE in the roots and nerves, with altered echogenicity and modification of internal nerve structure. A second‐line treatment was successfully started in three patients. Discussion UHF‐US allows for the evaluation of structural changes in the nerve. NE and alterations in internal structure can be considered ultrasound markers of disease severity, guiding therapeutic decisions.
ISSN:2162-3279

Similar Items