title: Ultrasound differentiation of axonal and demyelinating neuropathies.
abstract: BACKGROUND
  Ultrasound can be used to visualize peripheral nerve abnormality. Our objective in this study was to prove whether nerve ultrasound can differentiate between axonal and demyelinating polyneuropathies (PNPs).
  
  
  METHODS
  Systematic ultrasound measurements of peripheral nerves were performed in 53 patients (25 with demyelinating, 20 with axonal, 8 with mixed neuropathy) and 8 healthy controls. Nerve conduction studies of corresponding nerves were undertaken.
  
  
  RESULTS
  Analysis of variance revealed significant differences between the groups with regard to motor conduction velocity, compound muscle action potential amplitude, and cross-sectional area (CSA) of different nerves at different locations. Receiver operating characteristic curve analysis revealed CSA measurements to be well suited for detection of demyelinating neuropathies, and boundary values of peripheral nerve CSA could be defined.
  
  
  CONCLUSIONS
  Systematic ultrasound CSA measurement in different nerves helped detect demyelination, which is an additional cue in the etiological diagnosis of PNP, along with nerve conduction studies and nerve biopsy.
authors.affiliation: Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany; Department of Neurology, Basel University Hospital, Petersgraben 4 CH-4000, Basel, Switzerland; Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Grimm
authors.forename: Bianka
authors.initials: B
authors.lastname: Heiling
authors.forename: Ulrike
authors.initials: U
authors.lastname: Schumacher
authors.forename: Otto W
authors.initials: OW
authors.lastname: Witte
authors.forename: Hubertus
authors.initials: H
authors.lastname: Axer
mesh_terms: D000200:Action Potentials / Q000502:physiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016022:Case-Control Studies; D003711:Demyelinating Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D056768:Giant Axonal Neuropathy / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D009468:Neuromuscular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010525:Peripheral Nerves / Q000000981:diagnostic imaging / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D011446:Prospective Studies; D012372:ROC Curve; D014463:Ultrasonography
keywords: axonal polyneuropathy; cross-sectional area; demyelinating polyneuropathy; nerve ultrasound; neurophysiology