Journal Article

DZNE-2020-01445

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Peripheral Nerve Imaging Aids in the Diagnosis of Immune-Mediated Neuropathies—A Case Series

Dörner, M. (Corresponding author) ; Schreiber, F.DZNE* ; Stephanik, H. ; Tempelmann, C. ; Winter, N. ; Stahl, J.-H. ; Wittlinger, J. ; Willikens, S. ; Kramer, M. ; Heinze, H.-J.DZNE* ; Vielhaber, S.DZNE* ; Schelle, T. ; Grimm, A. ; Schreiber, S. (Last author)DZNE*

2020
MDPI Basel

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Please use a persistent id in citations: doi:10.3390/diagnostics10080535

Abstract: Background: Diagnosis of immune-mediated neuropathies and their differentiation from amyotrophic lateral sclerosis (ALS) can be challenging, especially at early disease stages. Accurate diagnosis is, however, important due to the different prognosis and available treatment options. We present one patient with a left-sided dorsal flexor paresis and initial suspicion of ALS and another with multifocal sensory deficits. In both, peripheral nerve imaging was the key for diagnosis. Methods: We performed high-resolution nerve ultrasound (HRUS) and 7T or 3T magnetic resonance neurography (MRN). Results: In both patients, HRUS revealed mild to severe, segmental or inhomogeneous, nerve enlargement at multiple sites, as well as an area increase of isolated fascicles. MRN depicted T2 hyperintense nerves with additional contrast-enhancement. Discussion: Peripheral nerve imaging was compatible with the respective diagnosis of an immune-mediated neuropathy, i.e., multifocal motor neuropathy (MMN) in patient 1 and multifocal acquired demyelinating sensory and motor neuropathy (MADSAM) in patient 2. Peripheral nerve imaging, especially HRUS, should play an important role in the diagnostic work-up for immune-mediated neuropathies and their differentiation from ALS.

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Contributing Institute(s):

1. U Clinical Researchers - Magdeburg (U Clinical Researchers - Magdeburg)
2. Clinical Neurophysiology and Memory (AG Düzel)

Research Program(s):

1. 342 - Disease Mechanisms and Model Systems (POF3-342) (POF3-342)
2. 344 - Clinical and Health Care Research (POF3-344) (POF3-344)

Appears in the scientific report 2020

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