Nerve ultrasound score in distinguishing chronic from acute inflammatory demyelinating polyneuropathy.
OBJECTIVE
Aim of this study was to develop and evaluate the applicability of an ultrasound score (Bochum ultrasound score - BUS) in distinguishing chronic (CIDP) from acute inflammatory demyelinating polyneuropathy (AIDP).


METHODS
Step 1: For the development of BUS 75 healthy-controls, 20 CIDP, 20 AIDP patients underwent US 4.55 ± 3.5 and 3.4 ± 2.91 years, respectively after onset. After comparing the distribution pattern and frequency of pathological US changes between the two study groups, we developed BUS, summarizing the cross sectional area (CSA) of: (1) the ulnar nerve in Guyons' canal, (2) the ulnar nerve in upper-arm, (3) the radial nerve in spiral groove, (4) the sural nerve between the gastrocnemius muscle. Step 2: The BUS underwent blinded evaluation in further 10 CIDP, 21 AIDP patients 3.8 ± 2.7 and 2.3 ± 1.5 years, respectively after onset. Step 3: The BUS underwent blinded, prospective evaluation in 8 patients with acute/subacute polyradiculoneuropathy (5 CIDP, 3 AIDP) 2.6 ± 1.8 weeks after onset.


RESULTS
The BUS showed a sensitivity of 90% and specificity of 90.4% (positive predictive value, PPV=81.8%; negative predictive value, NPV=95%) in distinguishing CIDP from AIDP, when they showed no differences in disease duration (p=0.0551).In addition, the BUS distinguished subacute-CIDP from AIDP with a sensitivity of 80%, specificity of 100% (PPV=100%, NPV=75%).


CONCLUSIONS
The BUS seems to allow a reliable distinction of CIDP from AIDP.


CONCLUSIONS
The BUS may be helpful in distinguishing subacute-CIDP from AIDP.
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany. Electronic address: antonis.kerasnoudis@gmail.com.
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Kerasnoudis
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany. Electronic address: kalliapit@yahoo.gr.
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Pitarokoili
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany. Electronic address: volker.behrendt@gmx.net.
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Behrendt
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany. Electronic address: Ralf.Gold@ruhr-uni-bochum.de.
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Gold
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany. Electronic address: min-suk.yoon@uni-due.de.
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Yoon
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D020275:Guillain-Barre Syndrome / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011826:Radial Nerve / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D013497:Sural Nerve / Q000000981:diagnostic imaging; D014459:Ulnar Nerve / Q000000981:diagnostic imaging; D014463:Ultrasonography / Q000592:standards
Acute inflammatory demyelinating polyneuropathy; Bochum ultrasound score; Chronic inflammatory demyelinating polyneuropathy; Cross sectional area; Guillain–Barre syndrome