Related Experiment Video
Updated: May 9, 2026
Nerve Ultrasound Protocol to Detect Dysimmune Neuropathies
Published on: October 7, 2021
Multifocal enlargement and increased vascularization of peripheral nerves detected by sonography in CIDP: a pilot
H S Goedee1, G J F Brekelmans1, L H Visser1
1Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands; Department of Clinical Neurophysiology, St. Elisabeth Hospital, Tilburg, The Netherlands.
Objective:
Detection of nerve enlargement in polyneuropathies by sonography is a new research area. No systematic investigation has been done yet in chronic inflammatory demyelinating polyneuropathy (CIDP). Therefore we investigated this in CIDP.
Methods:
Eleven patients with CIDP fulfilling the international criteria on CIDP underwent ultrasonographic examination of the median, ulnar, fibular and posterior tibial nerves and sometimes the brachial plexus bilaterally, using a standardized protocol. We assessed presence of nerve thickening and increased nerve vascularization.
Results:
In 7 of the 11 patients multiple nerve enlargements were detected: ulnar nerve 7, fibular nerve 5, posterior tibial nerve 4 and median nerve in 4 patients. The number of enlarged nerves was related with the MRC sum-score (p=0.03) and the total protein in the cerebrospinal fluid (CSF) at diagnosis (p=0.02). Increased vascularization was seen in 6 of the 11 patients: 4 in one nerve and in 2 in multiple nerves. The number of nerves with increased vascularization was associated with the number of enlarged nerves (p=0.01) and total protein in the CSF (p=0.006).
Conclusion:
Multiple nerve enlargements occur in CIDP showing a relation with a lower MRC sum-score, increased nerve vascularization and a higher total protein of the CSF.
Significance:
Our findings of nerve enlargement and increased nerve vascularization may be tools to monitor disease activity in CIDP, but further studies are needed.
