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Nerve Ultrasound Protocol to Detect Dysimmune Neuropathies
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[2013: what's new in inflammatory neuropathies]
1Département des neurosciences cliniques, université de Lausanne, CHU Vaudois (CHUV), BH07/413, rue du Bugnon 46, 1011 Lausanne, Suisse.
Revue Neurologique
|December 3, 2014
Summary
This review covers 2013 advances in Guillain-Barré syndrome and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Key updates include diagnostic insights, new models, and treatment considerations for these rare neurological disorders.
Area of Science:
- Neurology
- Immunology
- Clinical Trials
Context:
- 2013 saw significant publications and trial initiations in Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).
- Advances in understanding diagnostic limits and pathophysiology for GBS and CIDP were reported.
- New research tools, including a mouse model for GBS, emerged.
Purpose:
- To summarize key advancements in GBS and CIDP research and clinical practice from 2013.
- To highlight progress in diagnostic criteria, understanding disease mechanisms, and therapeutic strategies.
- To discuss emerging treatments and the evolving role of imaging in peripheral neuropathies.
Summary:
- For GBS, updates include the IGOS launch, refined diagnostic understanding, influenza vaccine effects, and improved care, though analgesic use remains uncertain. A novel mouse model was introduced.
- CIDP research focused on diagnostic pitfalls, improved pathophysiological insights, and demonstrated the value of functional monitoring. Intravenous immunoglobulin (IVIG) efficacy duration and corticosteroid sensitivity, including dexamethasone, were noted.
- Ongoing trials for fingolimod in CIDP are pending. Progress in multifocal motor neuropathy, inflammatory plexopathy, and anti-MAG neuropathy is discussed, emphasizing established treatments and advancements in peripheral nerve imaging.
Impact:
- Enhanced diagnostic capabilities and a deeper understanding of GBS and CIDP pathophysiology.
- Demonstrated the utility of functional monitoring scores in CIDP management.
- Provided an overview of current and emerging therapeutic options, guiding clinical practice and future research in peripheral neuropathies.
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