High resolution sonography in the evaluation of the peripheral nervous system in polyneuropathy - a review of the literature

H. S. Goedee, G. J. F. Brekelmans, J. T. H. van Asseldonk, R. Beekman, W. H. Mess, L. H. Visser*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Clinical, laboratory and electrodiagnostic studies are the mainstay in the diagnosis of polyneuropathy. An accurate etiological diagnosis is of paramount importance to provide the appropriate treatment, prognosis and genetic counselling. High resolution sonography of the peripheral nervous system allows nerves to be readily visualized and to assess their morphology. Ultrasonography has brought pathophysiological insights and substantially added to diagnostic accuracy and treatment decisions amongst mononeuropathies. In this study the literature on its clinical application in polyneuropathy is reviewed. Several polyneuropathies have been studied by means of ultrasound: Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies, chronic inflammatory demyelinating polyneuropathy, Guillain-Barre syndrome, multifocal motor neuropathy, paraneoplastic polyneuropathy, leprosy and diabetic neuropathy. The most prominent reported pathological changes were nerve enlargement, increased hypo-echogenicity and increased intraneural vascularization. Sonography revealed intriguingly different patterns of nerve enlargement between inflammatory neuropathies and axonal and inherited polyneuropathies. However, many studies concerned case reports or case series and showed methodological shortcomings. Further prospective studies with standardized protocols for nerve sonography and clinical and electrodiagnostic testing are needed to determine the role of nerve sonography in inherited and acquired polyneuropathies.
Original languageEnglish
Pages (from-to)1342-1351
JournalEuropean Journal of Neurology
Issue number10
Publication statusPublished - Oct 2013


  • electrodiagnostic studies
  • EMG
  • peripheral
  • nervous system
  • polyneuropathy
  • sonography
  • ultrasound


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