Clinical Neurophysiology
Volume 129, Issue 1, 2018, Pages 232-237

High-resolution ultrasound in patients with Wartenberg's migrant sensory neuritis, a case-control study (Article)

Herraets I.J.T. , Goedee H.S. , Telleman J.A. , van Asseldonk J.-T.H. , Visser L.H. , van der Pol W.L.* , van den Berg L.H.
  • a Department of Neurology, Brain Center Rudolf Magnus, UMC Utrecht, Heidelberglaan 100, CX Utrecht, 3584, Netherlands, Department of Neurology and Clinical Neurophysiology, Elisabeth–Tweesteden Hospital, Hilvarenbeekseweg 60, GC Tilburg, 5022, Netherlands
  • b Department of Neurology, Brain Center Rudolf Magnus, UMC Utrecht, Heidelberglaan 100, CX Utrecht, 3584, Netherlands
  • c Department of Neurology, Brain Center Rudolf Magnus, UMC Utrecht, Heidelberglaan 100, CX Utrecht, 3584, Netherlands, Department of Neurology and Clinical Neurophysiology, Elisabeth–Tweesteden Hospital, Hilvarenbeekseweg 60, GC Tilburg, 5022, Netherlands
  • d Department of Neurology and Clinical Neurophysiology, Elisabeth–Tweesteden Hospital, Hilvarenbeekseweg 60, GC Tilburg, 5022, Netherlands
  • e Department of Neurology and Clinical Neurophysiology, Elisabeth–Tweesteden Hospital, Hilvarenbeekseweg 60, GC Tilburg, 5022, Netherlands
  • f Department of Neurology, Brain Center Rudolf Magnus, UMC Utrecht, Heidelberglaan 100, CX Utrecht, 3584, Netherlands
  • g Department of Neurology, Brain Center Rudolf Magnus, UMC Utrecht, Heidelberglaan 100, CX Utrecht, 3584, Netherlands

Abstract

Objective Wartenberg's migrant sensory neuritis (WMSN) is a rare, patchy, pure sensory neuropathy of unknown etiology. High-resolution ultrasonography (HRUS) is an emerging diagnostic technique for neuropathies, but it has not been applied in WMSN. In this study we aimed to determine HRUS abnormalities in WMSN. Methods We performed a case-control study of 8 newly diagnosed patients with WMSN and 22 treatment-naive disease controls (16 patients with pure sensory axonal neuropathy and 6 with pure sensory chronic inflammatory demyelinating polyneuropathy (CIDP) or Lewis-Sumner syndrome (LSS)). All patients underwent routine diagnostic evaluations and a predefined HRUS protocol. Results We found multifocal nerve enlargement in all 8 WMSN patients. The median nerve in the upper arm and the sural nerve were significantly larger in WMSN than in axonal controls (p = 0.01 and p = 0.04). In CIDP/LSS, sonographic enlargement was more extensive. Furthermore we found brachial plexus involvement in 3 of 8 (38%) WMSN patients. Conclusion HRUS showed enlargement of multiple nerves in all WMSN patients even if clinical testing and NCS were normal. Significance The feature of multifocal nerve enlargement may be of additional value in establishing the diagnosis of WMSN and may support the suggestion of an auto-immune etiology. © 2017 International Federation of Clinical Neurophysiology

Author Keywords

Peripheral neuropathy Ultrasound Multifocal nerve enlargement Wartenberg's migrant sensory neuritis Nerve conduction studies

Index Keywords

median nerve neuritis Brachial Plexus axonal neuropathy sural nerve neuropathy Ultrasonography chronic inflammatory demyelinating polyneuropathy chronic idiopathic axonal polyneuropathy predictive value clinical feature diabetic axonal neuropathy human drug induced axonal polyneuropathy axon middle aged demyelinating disease Axons Demyelinating Autoimmune Diseases, CNS demyelinating neuropathy controlled study wartenberg migrant sensory neuritis priority journal pathology procedures disease duration vitamin deficiency diagnostic imaging Humans diagnostic value male female clinical article echography standards Article adult Predictive Value of Tests Case-Control Studies case control study
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85036583006&doi=10.1016%2fj.clinph.2017.10.040&partnerID=40&md5=ae2bbea9c0e153687f91ce91aeb58f75
DOI: 10.1016/j.clinph.2017.10.040
ISSN: 13882457
Cited by: 4
Original Language: English