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Nerve Ultrasound of Multifocal Motor Neuropathy and Motor and Typical Chronic Inflammatory Demyelinating Neuropathy

Published online by Cambridge University Press:  09 June 2025

Jingwen Niu Open the ORCID record for Jingwen Niu [Opens in a new window] ,
Qingyun Ding ,
Nan Hu ,
Liying Cui  and
Mingsheng Liu Open the ORCID record for Mingsheng Liu [Opens in a new window]
Jingwen Niu
Affiliation:
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng-qu, Beijing, China
Qingyun Ding
Affiliation:
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng-qu, Beijing, China
Nan Hu
Affiliation:
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng-qu, Beijing, China
Liying Cui
Affiliation:
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng-qu, Beijing, China
Mingsheng Liu*
Affiliation:
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng-qu, Beijing, China
*
Corresponding author: Mingsheng Liu; Email: liumingsheng_pumch@163.com
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Abstract

Objective:

Both multifocal motor neuropathy (MMN) and chronic inflammatory demyelinating polyneuropathy (CIDP) are chronic progressive immune-mediated peripheral neuropathies without sensory loss. We aimed to explore the different features of ultrasonographic and electrophysiological changes among MMN, motor CIDP and typical CIDP patients.

Methods:

Nerve ultrasonographic studies were performed in 19 patients with MMN, 15 patients with motor CIDP and 117 patients with typical CIDP. Cross-sectional areas (CSAs) were measured on the bilateral median and ulnar nerves and brachial plexus. Nerve conduction studies (NCSs) were performed on the median and ulnar nerves.

Results:

In patients with MMN and typical CIDP, the percentage enlargement in the brachial plexus (MMN 45.7%, typical CIDP 78%) was similar to that in the arm (MMN 42.9%, typical CIDP 76.8%) and forearm (MMN 42.9%, typical CIDP 79.4%). However, in patients with motor CIDP, the percentage enlargement in the brachial plexus (74.1%) was more pronounced than in the arm (65.5%) and forearm (58.6%). The CMAPerb/CMAPaxilla in MMN was significantly higher than in motor CIDP (median nerve, 0.82 ± 0.28 for MMN and 0.60 ± 0.37 for motor CIDP, P = 0.017). The CSA decreased in the order of typical CIDP, motor predominant CIDP (MPred-CIDP), pure motor CIDP (PM-CIDP) and MMN. The motor nerve conduction velocity increased in the order of typical CIDP, MPred-CIDP, PM-CIDP and MMN. A total of 3/6 PM-CIDP and 3/3 MPred-CIDP patients responded to steroid treatment.

Conclusion:

Treatment response, nerve ultrasonography and NCS in MMN, PM-CIDP, MPred-CIDP and typical CIDP constitute a spectrum.

Résumé

RÉSUMÉ

Échographie des nerfs dans le cas de la neuropathie motrice multifocale et de la neuropathie démyélinisante inflammatoire chronique typique et motrice.

Objectif :

La neuropathie motrice multifocale (NMM) et la polyneuropathie inflammatoire démyélinisante chronique (PIDC) sont des neuropathies périphériques chroniques progressives à médiation immunitaire et sans perte sensorielle. Nous avons ainsi cherché à explorer les différentes caractéristiques des changements échographiques et électrophysiologiques chez des patients atteints de NMM, de PIDC motrice et de PIDC typique.

Méthodes :

Des études par échographie des nerfs ont été effectuées chez 19 patients atteints de NMM, 15 patients atteints de PIDC motrice et 117 patients atteints de PIDC typique. Les surfaces de section transversale (SST) ont été mesurées sur les nerfs médian et ulnaire bilatéraux et sur le plexus brachial. Des études de conduction nerveuse (ECN) ont été menées sur les nerfs médian et cubital.

Résultats :

Chez les patients atteints de NMM et de PIDC typique, le pourcentage d’hypertrophie du plexus brachial (NMM 45,7 %, PIDC typique 78 %) était similaire à celui du bras (NMM 42,9 %, PIDC typique 76,8 %) et de l’avant-bras (NMM 42,9 %, PIDC typique 79,4 %). En revanche, chez les patients atteints de PIDC motrice, le pourcentage d’hypertrophie du plexus brachial (74,1 %) est plus prononcé que celui du bras (65,5 %) et de l’avant-bras (58,6 %). La CMAPerb/CMAPaxilla dans la NMM était significativement plus élevée que dans la PIDC motrice (nerf médian : 0,82 ± 0,28 pour la NMM et 0,60 ± 0,37 pour la PIDC motrice, p = 0,017). En ce qui concerne les SST, on a observé les diminutions les plus notables dans l’ordre suivant : PIDC typique, PIDC à prédominance motrice, PIDC purement motrice et NMM. La vitesse de conduction du nerf moteur a par ailleurs augmenté dans l’ordre suivant : PIDC typique, PIDC à prédominance motrice, PIDC purement motrice et NMM. Au total, 3 patients sur 6 atteints de PIDC purement motrice et 3 patients sur 3 patients atteints de PIDC à prédominance motrice ont répondu à des traitements par stéroïdes.

Conclusion :

La réponse aux traitements, l’échographie des nerfs et les ECN dans le cas de la NMM, de la PIDC purement motrice, de la PIDC à prédominance motrice et de la PIDC typique constituent un spectre (spectrum).

Keywords

multifocal motor neuropathynerve ultrasoundnerve conduction studiesmotor CIDPtypical CIDP

Information

Type
Original Article
Information
Canadian Journal of Neurological Sciences , First View , pp. 1 - 9
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation

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