Abstract
Background: Polyneuropathies (PNP) are a broad field of diseases affecting millions of people. While the symptoms presented are mostly similar, underlying causes are abundant. Thus, early identification of treatable causes is often difficult. Besides clinical data and basic laboratory findings, nerve conduction studies are crucial for etiological classification, yet limited. Besides Magnetic Resonance Imaging (MRI), high-resolution nerve ultrasound (HRUS) has become a noninvasive, fast, economic and available tool to help distinguish different types of nerve alterations in neuropathies. Methods: We aim to describe typical ultrasound findings in PNP and patterns of morphological changes in hereditary, immune-mediated, diabetic, metabolic and neurodegenerative PNP. Literature research was performed in PubMed using the terms ‘nerve ultrasound’, neuromuscular ultrasound, high-resolution nerve ultrasound, peripheral nerves, nerve enlargement, demyelinating, hereditary, polyneuropathies, hypertrophy’. Results: Plenty of studies over the past 20 years investigated the value of nerve ultrasound in different neuropathies. Next to nerve enlargement, patterns of nerve enlargement, echointensity, vascularization and elastography have been evaluated for diagnostic terms. Furthermore, different scores have been developed to distinguish different etiologies of PNP. Conclusions: Where morphological alterations of the nerves reflect underlying pathologies, early nerve ultrasound might enable a timely start of available treatment and also facilitate follow up of therapy success.
Highlights
Polyneuropathies are among the most frequent neurological disorders and cause significant morbidity and use of resources
Finding the cause of neuropathic deficits still remains a challenge in daily clinical routine
Technical tools have improved and nerve conduction studies, skin and nerve biopsy, generation sequencing, cerebrospinal fluid (CSF) analysis or antibody testing are established methods, the cause of PNP remains unclear in up to one third of patients. Imaging tools such as Magnetic Resonance Imaging (MRI) of the roots and nerves could contribute to the diagnosis of immune-mediated neuropathies, hereditary transthyretin (TTR) associated systemic amyloidosis and others in the recent past [1,2,3]
Summary
Polyneuropathies are among the most frequent neurological disorders and cause significant morbidity and use of resources. Technical tools have improved and nerve conduction studies, skin and nerve biopsy, generation sequencing, cerebrospinal fluid (CSF) analysis or antibody testing are established methods, the cause of PNP remains unclear in up to one third of patients. Imaging tools such as MRI of the roots and nerves could contribute to the diagnosis of immune-mediated neuropathies, hereditary transthyretin (TTR) associated systemic amyloidosis and others in the recent past [1,2,3]. Resonance Imaging (MRI), high-resolution nerve ultrasound (HRUS) has become a noninvasive, fast, economic and available tool to help distinguish different types of nerve alterations in neuropathies
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