Sonografie peripherer Nerven: Immun-Neuropathien

Zusammenfassung

Immun-Neuropathien sind seltene Erkrankungen, die allerdings frühzeitig einer kausalen Therapie zugeführt werden sollten, sodass es von großer Wichtigkeit ist, möglichst zuverlässig diese Immun-Neuropathie zu diagnostizieren. Der folgende Artikel hat zum Ziel, eine Übersicht über die typischen sonografischen Befunde sowie über den Zusatznutzen der Sonografie gegenüber der elektrophysiologischen Untersuchung bei Immun-Neuropathien wie der chronischen inflammatorischen demyelinisierenden Polyneuropathie (CIDP), systemischen Vaskulitiden, der multifokalen akquirieten demyelinisierenden sensiblen und motorischen Neuropathie (MADSAM), der multifokalen motorischen Neuropathie (MMN) und der neuralgischen Amyotrophie zu geben.

ABSTRACT

Immune-mediated neuropathies are rare diseases. However, because of the need for early causal treatment, it is of utmost importance to have a reliable diagnostic work-up for these neuropathies. This article aims to provide an overview of the typical sonographic findings and of the additional diagnostic value of sonography compared with electrodiagnostic studies in immune-mediated neuropathies such as chronic inflammatory demyelinating polyneuropathy (CIDP), systemic vasculitis, multifocal acquired demyelinating sensory and motor neuropathy, (MADSAM), multifocal motor neuropathy (MMN) and neuralgic amyotrophy.

Schlüsselwörter

Sonografie - periphere Nerven - Immun-Neuropathien - CIDP - MMN - neuralgische Amyotrophy

Key words

sonography of peripheral nerves - immune-mediated neuropathies - CIDP - MMN - neuralgic amyotrophy

• Literatur

• 1 Hanewinckel R, van Oijen M, Ikram MA. et al. The epidemiology and risk factors of chronic polyneuropathy. Eur J Epidemiol 2016; 31: 5-20
• 2 Hanewinckel R, Drenthen J, van Oijen M. et al. Prevalence of polyneuropathy in the general middle-aged and elderly population. Neurology 2016; 87: 1892-1898
• 3 Italian General Practitioner Study Group (IGPSG) . Chronic symmetric symptomatic polyneuropathy in the elderly: a field screening investigation in two Italian regions. I. Prevalence and general characteristics of the sample. Neurology 1995; 45: 1832-1836
• 4 Baldereschi M, Inzitari M, Di Carlo A. et al. ILSA Working Group Epidemiology of distal symmetrical neuropathies in the Italian elderly. Neurology 2007; 68: 1460-1467
• 5 Vallat JM, Sommer C, Magy L. Chronic inflammatory demyelinating polyradiculoneuropathy: diagnostic and therapeutic challenges for a treatable condition. Lancet Neurol 2010; 9: 402-412
• 6 Visser NA, Notermans NC, Linssen RS. et al. Incidence of polyneuropathy in Utrecht, the Netherlands. Neurology 2015; 84: 259-264
• 7 Van den Bergh PY, Hadden RD, Bouche P. et al. European Federation of Neurological Societies; Peripheral Nerve Society. European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society – first revision. Eur J Neurol 2010; 17: 356-363
• 8 Jang JH, Cho CS, Yang K-S. et al. Pattern analysis of nerve enlargement using ultrasonography in chronic inflammatory demyelinating polyneuropathy. Clin Neurophysiol 2014; 125: 1893 1899;
• 9 Padua L, Martinoli C, Pazzaglia C. et al. Intra- and internerve cross-sectional area variability: new ultrasound measures. Muscle Nerve 2012; 45: 730-733
• 10 Goedee HS, Brekelmans GJF, Visser LH. Multifocal enlargement and increased vascularization of peripheral nerves detected by sonography in CIDP: a pilot study. Clin Neurophysiol 2014; 125: 154-159
• 11 Yamashita T, Kwee TC, Takahara T. Whole-body magnetic resonance neurography. N Engl J Med 2009; 361: 538-539
• 12 Grimm A, Decard BF, Bischof A. et al. Ultrasound of the peripheral nerves in systemic vasculitic neuropathies. J Neurol Sci 2014; 347: 44-49
• 13 Schreiber S, Oldag A, Kornblum C. et al. Sonography of the median nerve in CMT1A, CMT2A, CMTX, and HNPP. Muscle Nerve 2013; 47: 385-395
• 14 Sugimoto T, Ochi K, Hosomi N. et al. Ultrasonographic nerve enlargement of the median and ulnar nerves and the cervical nerve roots in patients with demyelinating Charcot-Marie-Tooth disease: distinction from patients with chronic inflammatory demyelinating polyneuropathy. J Neurol 2013; 260: 2580-2587
• 15 Zaidman CM, Harms MB, Pestronk A. Ultrasound of inherited vs. acquired demyelinating polyneuropathies. J Neurol 2013; 260: 3115-3121
• 16 Scheidl E, Böhm J, Simó M. et al. Ultrasonography of MADSAM neuropathy: focal nerve enlargements at sites of existing and resolved conduction blocks. Neuromuscul Disord 2012; 22: 627-631
• 17 Kerasnoudis A, Pitarokoili K, Gold R. et al. Bochum ultrasound score allows distinction of chronic inflammatory from multifocal acquired demyelinating polyneuropathies. J Neurol Sci 2015; 348: 211-215
• 18 Rattay TW, Winter N, Décard B. et al. Nerve ultrasound as follow-up tool in treated multifocal motor neuropathy. Eur J Neurol 2017; 24: 1125-1134
• 19 Beekman R, van den Berg LH, Franssen H. et al. Ultrasonography shows extensive nerve enlargements in multifocal motor neuropathy. Neurology 2005; 65: 305-307
• 20 Foster E, Tsang BK, Kam A. et al. Hirayama disease. J Clin Neurosci 2015; 22: 951-954
• 21 van Alfen N, van Engelen BG. The clinical spectrum of neuralgic amyotrophy in 246 cases. Brain 2006; 129: 438-450
• 22 Feinberg JH, Radecki J. . Parsonage-turner syndrome.HSS J 2010; 6: 199-205
• 23 Sneag DB, Rancy SK, Wolfe SW. et al. Brachial plexitis or neuritis? MRI features of lesion distribution in Parsonage-Turner syndrome. Muscle Nerve 2018; 58: 359-366
• 24 Arányi Z, Csillik A, Dévay K. et al. Ultrasonographic identification of nerve pathology in neuralgic amyotrophy: Enlargement, constriction, fascicular entwinement, and torsion. Muscle Nerve 2015; 52: 503-511
• 25 Arányi Z, Csillik A, Dévay K. et al. Ultrasonography in neuralgic amyotrophy: Sensitivity, spectrum of findings, and clinical correlations. Muscle Nerve 2017; 56: 1054-1062
• 26 Akane M, Iwatsuki K, Tatebe M. et al. Anterior interosseous nerve and posterior interosseous nerve involvement in neuralgic amyotrophy. Clin Neurol Neurosurg 2016; 151: 108-112
• 27 Kerasnoudis A, Pitarokoili K, Behrendt V. et al. Nerve ultrasound score in distinguishing chronic from acute inflammatory demyelinating polyneuropathy. Clin Neurophysiol 2014; 125: 635-641
• 28 Grimm A, Decard BF, Axer H. et al. The Ultrasound pattern sum score - UPSS. A new method to differentiate acute and subacute neuropathies using ultrasound of the peripheral nerves. Clin Neurophysiol 2015; 126: 2216-2225
• 29 Kerasnoudis A, Pitarokoili K, Haghikia A. et al. Nerve ultrasound protocol in differentiating chronic immune-mediated neuropathies. Muscle Nerve. 2016; 54: 864-871
• 30 Grimm A, Vittore D, Schubert V. et al. Ultrasound pattern sum score, homogeneity score and regional nerve enlargement index for differentiation of demyelinating inflammatory and hereditary neuropathies. Clin Neurophysiol 2016; 127: 2618-2624
• 31 Kerasnoudis A, Pitarokoili K, Behrendt V. et al. Bochum ultrasound score versus clinical and electrophysiological parameters in distinguishing acute-onset chronic from acute inflammatory demyelinating polyneuropathy. Muscle Nerve 2015; 51: 846-852
• 32 Lucchetta M, Padua L, Granata G. et al. Nerve ultrasound findings in neuropathy associated with anti-myelin-associated glycoproteinantibodies. Eur J Neurol 2015; 22: 193-202
• 33 Athanasopoulou IM, Rasenack M, Grimm C. et al. Ultrasound of the nerves - An appropriate addition to nerve conduction studies to differentiate paraproteinemic neuropathies. J Neurol Sci 2016; 362: 188-195
• 34 Padua L, Granata G, Sabatelli M. et al. Heterogeneity of root and nerve ultrasound pattern in CIDP patients. Clin Neurophysiol 2014; 125: 160-165
• 35 Härtig F, Ross M, Dammeier NM. et al. Nerve Ultrasound Predicts Treatment Response in Chronic Inflammatory Demyelinating Polyradiculoneuropathy – a Prospective Follow-Up. Neurotherapeutics 2018; 15: 439-451