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High resolution sonography in the evaluation of the peripheral nervous system in polyneuropathy – a review of the literature
Author(s) -
Goedee H. S.,
Brekelmans G. J. F.,
Asseldonk J. T. H.,
Beekman R.,
Mess W. H.,
Visser L. H.
Publication year - 2013
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12182
Subject(s) - medicine , polyneuropathy , peripheral nervous system , nervous system , peripheral , high resolution , pathology , neuroscience , central nervous system , psychiatry , remote sensing , biology , geology
Clinical, laboratory and electrodiagnostic studies are the mainstay in the diagnosis of polyneuropathy. An accurate etiological diagnosis is of paramount importance to provide the appropriate treatment, prognosis and genetic counselling. High resolution sonography of the peripheral nervous system allows nerves to be readily visualized and to assess their morphology. Ultrasonography has brought pathophysiological insights and substantially added to diagnostic accuracy and treatment decisions amongst mononeuropathies. In this study the literature on its clinical application in polyneuropathy is reviewed. Several polyneuropathies have been studied by means of ultrasound: C harcot– M arie– T ooth, hereditary neuropathy with liability to pressure palsies, chronic inflammatory demyelinating polyneuropathy, G uillain‐ B arré syndrome, multifocal motor neuropathy, paraneoplastic polyneuropathy, leprosy and diabetic neuropathy. The most prominent reported pathological changes were nerve enlargement, increased hypo‐echogenicity and increased intraneural vascularization. Sonography revealed intriguingly different patterns of nerve enlargement between inflammatory neuropathies and axonal and inherited polyneuropathies. However, many studies concerned case reports or case series and showed methodological shortcomings. Further prospective studies with standardized protocols for nerve sonography and clinical and electrodiagnostic testing are needed to determine the role of nerve sonography in inherited and acquired polyneuropathies.