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Clin Neurophysiol. 2014 Mar;125(3):635-41. doi: 10.1016/j.clinph.2013.08.014. Epub 2013 Sep 23.

Nerve ultrasound score in distinguishing chronic from acute inflammatory demyelinating polyneuropathy.

Author information

1
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany. Electronic address: antonis.kerasnoudis@gmail.com.
2
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany. Electronic address: kalliapit@yahoo.gr.
3
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany. Electronic address: volker.behrendt@gmx.net.
4
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany. Electronic address: Ralf.Gold@ruhr-uni-bochum.de.
5
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany. Electronic address: min-suk.yoon@uni-due.de.

Abstract

OBJECTIVE:

Aim of this study was to develop and evaluate the applicability of an ultrasound score (Bochum ultrasound score - BUS) in distinguishing chronic (CIDP) from acute inflammatory demyelinating polyneuropathy (AIDP).

METHODS:

Step 1: For the development of BUS 75 healthy-controls, 20 CIDP, 20 AIDP patients underwent US 4.55 ± 3.5 and 3.4 ± 2.91 years, respectively after onset. After comparing the distribution pattern and frequency of pathological US changes between the two study groups, we developed BUS, summarizing the cross sectional area (CSA) of: (1) the ulnar nerve in Guyons' canal, (2) the ulnar nerve in upper-arm, (3) the radial nerve in spiral groove, (4) the sural nerve between the gastrocnemius muscle. Step 2: The BUS underwent blinded evaluation in further 10 CIDP, 21 AIDP patients 3.8 ± 2.7 and 2.3 ± 1.5 years, respectively after onset. Step 3: The BUS underwent blinded, prospective evaluation in 8 patients with acute/subacute polyradiculoneuropathy (5 CIDP, 3 AIDP) 2.6 ± 1.8 weeks after onset.

RESULTS:

The BUS showed a sensitivity of 90% and specificity of 90.4% (positive predictive value, PPV=81.8%; negative predictive value, NPV=95%) in distinguishing CIDP from AIDP, when they showed no differences in disease duration (p=0.0551).In addition, the BUS distinguished subacute-CIDP from AIDP with a sensitivity of 80%, specificity of 100% (PPV=100%, NPV=75%).

CONCLUSION:

The BUS seems to allow a reliable distinction of CIDP from AIDP.

SIGNIFICANCE:

The BUS may be helpful in distinguishing subacute-CIDP from AIDP.

KEYWORDS:

Acute inflammatory demyelinating polyneuropathy; Bochum ultrasound score; Chronic inflammatory demyelinating polyneuropathy; Cross sectional area; Guillain–Barre syndrome

PMID:
24070674
DOI:
10.1016/j.clinph.2013.08.014
[Indexed for MEDLINE]
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