High-resolution ultrasound in patients with Wartenberg’s migrant sensory neuritis, a case-control study

Publication date: January 2018
Source:Clinical Neurophysiology, Volume 129, Issue 1
Author(s): Ingrid J.T. Herraets, H. Stephan Goedee, Johan A. Telleman, Jan-Thies H. van Asseldonk, Leo H. Visser, W. Ludo van der Pol, Leonard H. van den Berg
ObjectiveWartenberg's migrant sensory neuritis (WMSN) is a rare, patchy, pure sensory neuropathy of unknown etiology. High-resolution ultrasonography (HRUS) is an emerging diagnostic technique for neuropathies, but it has not been applied in WMSN. In this study we aimed to determine HRUS abnormalities in WMSN.MethodsWe performed a case-control study of 8 newly diagnosed patients with WMSN and 22 treatment-naive disease controls (16 patients with pure sensory axonal neuropathy and 6 with pure sensory chronic inflammatory demyelinating polyneuropathy (CIDP) or Lewis-Sumner syndrome (LSS)). All patients underwent routine diagnostic evaluations and a predefined HRUS protocol.ResultsWe found multifocal nerve enlargement in all 8 WMSN patients. The median nerve in the upper arm and the sural nerve were significantly larger in WMSN than in axonal controls (p = 0.01 and p = 0.04). In CIDP/LSS, sonographic enlargement was more extensive. Furthermore we found brachial plexus involvement in 3 of 8 (38%) WMSN patients.ConclusionHRUS showed enlargement of multiple nerves in all WMSN patients even if clinical testing and NCS were normal.SignificanceThe feature of multifocal nerve enlargement may be of additional value in establishing the diagnosis of WMSN and may support the suggestion of an auto-immune etiology.



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