title: Nerve size in chronic inflammatory demyelinating neuropathy varies with disease activity and therapy response over time: a retrospective ultrasound study.
abstract: BACKGROUND
  Nerves are often enlarged in chronic inflammatory demyelinating polyneuropathy (CIDP). In this investigation we studied changes with treatment over time.
  
  
  METHODS
  We retrospectively compared serial ultrasound measurements of median and ulnar nerve size with clinical and electrodiagnostic evaluations in 23 CIDP subjects. We defined remission as stable clinical improvement on low or decreasing amounts of medication.
  
  
  RESULTS
  Nerves were normal at last follow-up more often in subjects who achieved remission than in those who did not (10 of 13 vs. 0 of 10, P = 0.0001). Nerves were normal or smaller (>30% reduction) more often in subjects whose grip strength improved or remained strong compared those whose grip strength weakened (12 of 16 vs. 0 of 3, P = 0.04), and in subjects whose demyelinating electrodiagnostic features resolved compared with those whose demyelination persisted (7 of 7 vs. 6 of 12, P = 0.04). Over time, nerve size decreased more in subjects with baseline nerve enlargement who achieved remission than in those who did not (-41% vs. 7%, P = 0.04).
  
  
  CONCLUSIONS
  In CIDP, enlarged nerves normalized or decreased with remission.
authors.affiliation: Department of Neurology, Washington University School of Medicine, 660 South Euclid Avenue, Box 8111, St. Louis, Missouri, 63110, USA.
authors.forename: Craig M
authors.initials: CM
authors.lastname: Zaidman
authors.forename: Alan
authors.initials: A
authors.lastname: Pestronk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004568:Electrodiagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000187:drug effects; D009431:Neural Conduction / Q000502:physiology; D009460:Neurologic Examination; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D012189:Retrospective Studies; D013127:Spinal Nerves / Q000473:pathology* / Q000503:physiopathology / Q000648:ultrastructure*; D013997:Time Factors; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors
keywords: chronic inflammatory demyelinating polyneuropathy; longitudinal; nerve; peripheral neuropathy; treatment; ultrasound