Nerve ultrasound protocol in differentiating chronic immune-mediated neuropathies

INTRODUCTION: In this study we evaluated a new neuropathy ultrasound protocol (NUP) for differentiating chronic immune-mediated neuropathies. METHODS: The NUP was evaluated in 110 patients with clinical presentations of chronic immune-mediated neuropathy. All patients were first evaluated clinically and electrophysiologically and divided into 4 polyneuropathy groups: (a) symmetric demyelinating; (b) symmetric axonal; (c) asymmetric demyelinating; and (d) asymmetric axonal. During step 2, the NUP was evaluated prospectively for all 4 study groups. RESULTS: Overall, the NUP led to correct classification in 42 of 49 (85.7%) patients with chronic inflammatory demyelinating polyneuropathy (CIDP), 13 of 15 (86.9%) with multifocal motor neuropathy (MMN), and 5 of 5 (100%) with multifocal-acquired demyelinating sensory and motor neuropathy (MADSAM). The NUP had >80% sensitivity and specificity in distinguishing CIDP, MMN, and MADSAM in all 4 study groups. CONCLUSIONS: The NUP is a useful addition in the differential diagnosis of chronic immune-mediated neuropathies in everyday practice. Muscle Nerve 54: 864-871, 2016.