title: Ultrasound of the peripheral nerves in systemic vasculitic neuropathies.
abstract: BACKGROUND
  Ultrasound of the peripheral nerves (PNUS) can be used to visualize nerve pathologies in polyneuropathies (PNP). The aim of this study was to investigate, whether PNUS provides additional information in patients with proven systemic vasculitic neuropathies (VN).
  
  
  METHODS
  Systematic ultrasound measurements of several peripheral nerves, the vagal nerve and the 6th cervical nerve root were performed in 14 patients and 22 healthy controls. Nerve conduction studies of the corresponding nerves were undertaken. Finally, the measured results were compared to a study population of demyelinating immune-mediated and axonal neuropathies.
  
  
  RESULTS
  Patients with VN displayed significant smaller amplitudes of compound muscle action potentials (CMAP) (p<0.05) and sensory nerve action potentials (SNAP) compared to healthy controls, while conduction velocity did not differ between groups. The mean nerve cross-sectional areas (CSA) were increased in several peripheral nerves compared to the controls, most prominent in tibial and fibular nerve (p<0.01). PNUS revealed nerve enlargement in most of the clinically and electrophysiologically affected nerves (22 out of 31) in VN. Nerve enlargement was more often seen in vasculitic neuropathies than in other axonal neuropathies, but significantly rarer than in demyelinating neuropathies.
  
  
  CONCLUSIONS
  Focal CSA enlargement in one or more nerves in electrophysiologically axonal neuropathies can be a hint for VN and thus facilitate diagnostic and therapeutic procedures.
authors.affiliation: Department of Neurology, Basel University Hospital, Switzerland; Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany. Electronic address: alexander.grimm@usb.ch.
authors.forename: Alexander
authors.initials: A
authors.lastname: Grimm
authors.affiliation: Department of Neurology, Basel University Hospital, Switzerland.
authors.forename: Bernhard F
authors.initials: BF
authors.lastname: Décard
authors.affiliation: Department of Neurology, Basel University Hospital, Switzerland; Clinical Immunology, Basel University Hospital Basel, Switzerland.
authors.forename: Antje
authors.initials: A
authors.lastname: Bischof
authors.affiliation: Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany; Center for Sepsis Control and Care (CSCC), Jena University Hospital, Germany.
authors.forename: Hubertus
authors.initials: H
authors.lastname: Axer
mesh_terms: D000200:Action Potentials; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001369:Axons / Q000000981:diagnostic imaging; D003711:Demyelinating Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D010525:Peripheral Nerves / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D010523:Peripheral Nervous System Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D013126:Spinal Nerve Roots / Q000000981:diagnostic imaging / Q000503:physiopathology; D014463:Ultrasonography; D014630:Vagus Nerve / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: Axonal polyneuropathy; Mononeuritis multiplex; Nerve ultrasound; Peripheral nerve system; Vasculitic polyneuropathy; Vasculitis