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01-07-2015 | Original Communication

Neuroimaging in diagnosis of atypical polyradiculoneuropathies: report of three cases and review of the literature

Authors: Roberto Gasparotti, Marta Lucchetta, Mario Cacciavillani, Walter Neri, Carlo Guidi, Tiziana Cavallaro, Sergio Ferrari, Luca Padua, Chiara Briani

Published in: Journal of Neurology | Issue 7/2015

Abstract

Neuroimaging is increasingly used in the study of peripheral nerve diseases, and sometimes may have a pivotal role in the diagnostic process. We report on three patients with atypical chronic inflammatory polyradiculoneuropathy (CIDP) in whom magnetic resonance imaging (MRI) and nerve Ultrasound (US) were crucial for a correct diagnostic work-out. A literature review on MRI and US in acquired demyelinating polyneuropathies is also provided. Awareness of the imaging features of CIDP will assist in confirmation of the diagnosis, institution of the appropriate therapy, and prevention of inadequate or delayed treatment in atypical CIDP.

Mathey EK, Park SB, Hughes RA, Pollard JD, Armati PJ, Barnett MH, Taylor BV, Dyck PJ, Kiernan MC, Lin CS (2015) Chronic inflammatory demyelinating polyradiculoneuropathy: from pathology to phenotype. J Neurol Neurosurg Psychiatry. doi:10.1136/jnnp-2014-309697 PubMedCentralPubMed

Khadilkar SV, Yadav RS, Soni G (2015) A practical approach to enlargement of nerves, plexuses and roots. Pract Neurol. doi:10.1136/practneurol-2014-001004 PubMed

European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of multifocal motor neuropathy (2010) Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society–first revision. J Peripher Nerv Syst 15:295–301CrossRef

Van den Bergh PY, Hadden RD, Bouche P, Cornblath DR, Hahn A, Illa I, Koski CL, Leger JM, Nobile-Orazio E, Pollard J, Sommer C, van Doorn PA, van Schaik IN (2010) 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 17:356–363CrossRefPubMed

Thawait SK, Chaudhry V, Thawait GK, Wang KC, Belzberg A, Carrino JA, Chhabra A (2011) High-resolution MR neurography of diffuse peripheral nerve lesions. AJNR Am J Neuroradiol 32:1365–1372CrossRefPubMed

Chhabra A, Deune GE, Murano E, Prince JL, Soldatos T, Flammang A (2012) Advanced MR neurography imaging of radial nerve entrapment at the spiral groove: a case report. J Reconstr Microsurg 28:263–266CrossRefPubMed

Hobson-Webb LD, Padua L (2009) Median nerve ultrasonography in carpal tunnel syndrome: findings from two laboratories. Muscle Nerve 40:94–97CrossRefPubMed

Padua L, Liotta G, Di PA, Granata G, Pazzaglia C, Caliandro P, Martinoli C (2012) Contribution of ultrasound in the assessment of nerve diseases. Eur J Neurol 19:47–54CrossRefPubMed

Zaidman CM, Al-Lozi M, Pestronk A (2009) Peripheral nerve size in normals and patients with polyneuropathy: an ultrasound study. Muscle Nerve 40:960–966CrossRefPubMed

10.

Franca MC Jr, Faria AV, Queiroz LS, Nucci A (2007) Myositis with sensory neuronopathy. Muscle Nerve 36:721–725CrossRefPubMed

11.

Tazawa K, Matsuda M, Yoshida T, Shimojima Y, Gono T, Morita H, Kaneko T, Ueda H, Ikeda S (2008) Spinal nerve root hypertrophy on MRI: clinical significance in the diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy. Intern Med 47:2019–2024CrossRefPubMed

12.

Won SJ, Kim BJ, Park KS, Kim SH, Yoon JS (2012) Measurement of cross-sectional area of cervical roots and brachial plexus trunks. Muscle Nerve 46:711–716CrossRefPubMed

13.

Schady W, Goulding PJ, Lecky BR, King RH, Smith CM (1996) Massive nerve root enlargement in chronic inflammatory demyelinating polyneuropathy. J Neurol Neurosurg Psychiatry 61:636–640PubMedCentralCrossRefPubMed

14.

Mizuno K, Nagamatsu M, Hattori N, Yamamoto M, Goto H, Kuniyoshi K, Sobue G (1998) Chronic inflammatory demyelinating polyradiculoneuropathy with diffuse and massive peripheral nerve hypertrophy: distinctive clinical and magnetic resonance imaging features. Muscle Nerve 21:805–808CrossRefPubMed

15.

Crino PB, Grossman RI, Rostami A (1993) Magnetic resonance imaging of the cauda equina in chronic inflammatory demyelinating polyneuropathy. Ann Neurol 33:311–313CrossRefPubMed

16.

Bertorini T, Halford H, Lawrence J, Vo D, Wassef M (1995) Contrast-enhanced magnetic resonance imaging of the lumbosacral roots in the dysimmune inflammatory polyneuropathies. J Neuroimaging 5:9–15PubMed

17.

Midroni G, de Tilly LN, Gray B, Vajsar J (1999) MRI of the cauda equina in CIDP: clinical correlations. J Neurol Sci 170:36–44CrossRefPubMed

18.

Duarte J, Martinez AC, Rodriguez F, Mendoza A, Sempere AP, Claveria LE (1999) Hypertrophy of multiple cranial nerves and spinal roots in chronic inflammatory demyelinating neuropathy. J Neurol Neurosurg Psychiatry 67:685–687PubMedCentralCrossRefPubMed

19.

Duggins AJ, McLeod JG, Pollard JD, Davies L, Yang F, Thompson EO, Soper JR (1999) Spinal root and plexus hypertrophy in chronic inflammatory demyelinating polyneuropathy. Brain 122(Pt 7):1383–1390CrossRefPubMed

20.

Kuwabara S, Nakajima M, Matsuda S, Hattori T (1997) Magnetic resonance imaging at the demyelinative foci in chronic inflammatory demyelinating polyneuropathy. Neurology 48:874–877CrossRefPubMed

21.

Bradley LJ, Wilhelm T, King RH, Ginsberg L, Orrell RW (2006) Brachial plexus hypertrophy in chronic inflammatory demyelinating polyradiculoneuropathy. Neuromuscul Disord 16:126–131CrossRefPubMed

22.

Vlam L, van der Pol WL, Cats EA, Straver DC, Piepers S, Franssen H, van den Berg LH (2012) Multifocal motor neuropathy: diagnosis, pathogenesis and treatment strategies. Nat Rev Neurol 8:48–58CrossRef

23.

van Asseldonk JT, van den Berg LH, Van den Berg-Vos RM, Wieneke GH, Wokke JH, Franssen H (2003) Demyelination and axonal loss in multifocal motor neuropathy: distribution and relation to weakness. Brain 126:186–198CrossRefPubMed

24.

Ellegala DB, Monteith SJ, Haynor D, Bird TD, Goodkin R, Kliot M (2005) Characterization of genetically defined types of Charcot-Marie-Tooth neuropathies by using magnetic resonance neurography. J Neurosurg 102:242–245CrossRefPubMed

25.

Sinclair CD, Miranda MA, Cowley P, Morrow JM, Davagnanam I, Mehta H, Hanna MG, Koltzenburg M, Reilly MM, Yousry TA, Thornton JS (2011) MRI shows increased sciatic nerve cross sectional area in inherited and inflammatory neuropathies. J Neurol Neurosurg Psychiatry 82:1283–1286CrossRefPubMed

26.

Filler AG, Maravilla KR, Tsuruda JS (2004) MR neurography and muscle MR imaging for image diagnosis of disorders affecting the peripheral nerves and musculature. Neurol Clin 22:643–647CrossRefPubMed

27.

Shibuya K, Sugiyama A, Ito SI, Misawa S, Sekiguchi Y, Mitsuma S, Iwai Y, Watanabe K, Shimada H, Kawaguchi H, Suhara T, Yokota H, Matsumoto H, Kuwabara S (2015) Reconstruction magnetic resonance neurography in chronic inflammatory demyelinating polyneuropathy. Ann Neurol 77:333–337CrossRefPubMed

28.

Adachi Y, Sato N, Okamoto T, Sasaki M, Komaki H, Yamashita F, Kida J, Takahashi T, Matsuda H (2011) Brachial and lumbar plexuses in chronic inflammatory demyelinating polyradiculoneuropathy: MRI assessment including apparent diffusion coefficient. Neuroradiology 53:3–11CrossRefPubMed

29.

Kakuda T, Fukuda H, Tanitame K, Takasu M, Date S, Ochi K, Ohshita T, Kohriyama T, Ito K, Matsumoto M, Awai K (2011) Diffusion tensor imaging of peripheral nerve in patients with chronic inflammatory demyelinating polyradiculoneuropathy: a feasibility study. Neuroradiology 53:955–960CrossRefPubMed

30.

Beekman R, Visser LH (2004) High-resolution sonography of the peripheral nervous system—a review of the literature. Eur J Neurol 11:305–314CrossRefPubMed

31.

Bianchi S (2008) Ultrasound of the peripheral nerves. Joint Bone Spine 75:643–649CrossRefPubMed

32.

Matsuoka N, Kohriyama T, Ochi K, Nishitani M, Sueda Y, Mimori Y, Nakamura S, Matsumoto M (2004) Detection of cervical nerve root hypertrophy by ultrasonography in chronic inflammatory demyelinating polyradiculoneuropathy. J Neurol Sci 219:15–21CrossRefPubMed

33.

Cartwright MS, Passmore LV, Yoon JS, Brown ME, Caress JB, Walker FO (2008) Cross-sectional area reference values for nerve ultrasonography. Muscle Nerve 37:566–571CrossRefPubMed

34.

Granata G, Pazzaglia C, Calandro P, Luigetti M, Martinoli C, Sabatelli M, Padua L (2009) Ultrasound visualization of nerve morphological alteration at the site of conduction block. Muscle Nerve 40:1068–1070CrossRefPubMed

35.

Scheidl E, Bohm J, Simo M, Rozsa C, Bereznai B, Kovacs T, Aranyi Z (2012) Ultrasonography of MADSAM neuropathy: focal nerve enlargements at sites of existing and resolved conduction blocks. Neuromuscul Disord 22:627–631CrossRefPubMed

36.

Zaidman CM, Harms MB, Pestronk A (2013) Ultrasound of inherited vs. acquired demyelinating polyneuropathies. J Neurol 260:3115–3121PubMedCentralCrossRefPubMed

37.

Zaidman CM, Seelig MJ, Baker JC, Mackinnon SE, Pestronk A (2013) Detection of peripheral nerve pathology: comparison of ultrasound and MRI. Neurology 80:1634–1640PubMedCentralCrossRefPubMed

38.

Padua L, Granata G, Sabatelli M, Inghilleri M, Lucchetta M, Luigetti M, Coraci D, Martinoli C, Briani C (2014) Heterogeneity of root and nerve ultrasound pattern in CIDP patients. Clin Neurophysiol 125:160–165CrossRefPubMed

39.

Jang JH, Cho CS, Yang KS, Seok HY, Kim BJ (2014) Pattern analysis of nerve enlargement using ultrasonography in chronic inflammatory demyelinating polyneuropathy. Clin Neurophysiol 125:1893–1899CrossRefPubMed

40.

Rajabally YA, Nicolas G, Pieret F, Bouche P, Van den Bergh PY (2009) Validity of diagnostic criteria for chronic inflammatory demyelinating polyneuropathy: a multicentre European study. J Neurol Neurosurg Psychiatry 80:1364–1368CrossRefPubMed

41.

Bouchard C, Lacroix C, Plante V, Adams D, Chedru F, Guglielmi JM, Said G (1999) Clinicopathologic findings and prognosis of chronic inflammatory demyelinating polyneuropathy. Neurology 52:498–503CrossRefPubMed

42.

Said G, Krarup C (2013) Chronic inflammatory demyelinative polyneuropathy. Handb Clin Neurol 115:403–413CrossRefPubMed

43.

Chhabra A, Andreisek G, Soldatos T, Wang KC, Flammang AJ, Belzberg AJ, Carrino JA (2011) MR neurography: past, present, and future. AJR Am J Roentgenol 197:583–591CrossRefPubMed

44.

Yamashita T, Kwee TC, Takahara T (2009) Whole-body magnetic resonance neurography. N Engl J Med 361:538–539CrossRefPubMed

Title: Neuroimaging in diagnosis of atypical polyradiculoneuropathies: report of three cases and review of the literature
Authors: Roberto Gasparotti
Marta Lucchetta
Mario Cacciavillani
Walter Neri
Carlo Guidi
Tiziana Cavallaro
Sergio Ferrari
Luca Padua
Chiara Briani
Publication date: 01-07-2015
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 7/2015
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-015-7770-z

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Neuroimaging in diagnosis of atypical polyradiculoneuropathies: report of three cases and review of the literature

Abstract

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