The Diagnostic Role of Neuromuscular Ultrasound in Chronic Inflammatory Demyelinating Polyneuropathy

Abstract

The immune-neuropathies are a heterogenous group of peripheral nerve disorders.
Their diagnostic classification is mainly based on the documentation of the distribution
pattern of peripheral nerve impairment and the results of nerve conduction studies.
Nerve conduction studies remain nowadays fundamental not only for the diagnosis
of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), but also for the followup
and measurement of response to immune-treatment. The challenge though of acquiring
the best static and dynamic image of the relevant nerve structures, led to the development
of high frequency ultrasound technology. Neuromuscular ultrasound has been able to detect
thickened or swollen roots, peripheral nerves or plexus, findings that are consistent with ongoing
inflammation, especially in cases of Chronic Inflammatory Demyelinating Polyneuropathy
(CIDP). Similar findings have been described also in other immune-mediated neuropathies
such as Guillain–Barré Syndrome (GBS), Multifocal Motor Neuropathy (MMN)
and Multifocal Acquired Demyelinating Sensory and Motor Neuropathy (MADSAM).
This review provides a timely update on the ultrasound findings of chronic inflammatory
demyelinating polyneuropathy.