High Resolution Nerve Ultrasound in the Diagnosis of Pure Neuritic Leprosy.

Objectives: We aimed to compare the clinical, electrophysiologic, and sonographic characteristics of commonly affected peripheral nerves in suspected cases of pure neuritic leprosy (PNL) and to describe an ultrasound-guided fine needle aspiration cytology (FNAC) procedure to improve diagnostic capabilities in PNL.

Methods: This retrospective study was carried out at Roy Neuro Care Centre, Ranchi, Jharkhand, India through revisiting charts of suspected cases of PNL from October 2022 to June 2024. The charts of individuals with a history, examination, and nerve ultrasound consistent with PNL were reviewed.

Expert consensus on the combined investigation of polyneuropathies with electrodiagnostic tests and neuromuscular ultrasound.

Consensus was sought from 17 nominated global expert leaders to provide guidance on the combined use of neuromuscular ultrasound (NMUS) and electrodiagnostic tests (EDX) in the investigation of peripheral neuropathy (PN) in clinical practice. Consensus was based on an initial systematic review of the literature by the experts themselves, followed by three anonymised surveys, using the Delphi method. No consensus was defined as < 60 % rating frequency.

Ultrasonographic Identification of Pacinian Corpuscles in the Hand: A Pilot Study of Technique and Reliability.

Introduction/aims: Pacinian corpuscles are end organs of the sensory nervous system. The size and superficial location of Pacinian corpuscles allows them to be visualized with high-resolution ultrasound. This pilot study sought to assess the reliability of Pacinian corpuscle counting in the hand using ultrasound.

Young child with MuSK myasthenia gravis: treatment and remission with rituximab.

Myasthenia gravis is an autoimmune disorder characterised by autoantibodies directed against postsynaptic receptors of the neuromuscular junction. Muscle-specific tyrosine kinase (MuSK) myasthenia gravis is a subtype of myasthenia gravis containing antibodies specific to the MuSK subunit of the motor endplate. MuSK myasthenia gravis tends to display a severe clinical course, and most patients are refractory to treatment.

The Role of Ultrasound in the Evaluation of Tardive Dyskinesia: A Case Series.

Background: Despite efforts to visualize all the movements of tongue and oropharynx in individuals with focal movement disorders (specifically tardive dyskinesia (TD)), clinicians can miss the complete picture and additional tools may be required to reach an accurate diagnosis.

Cases: We present three cases with TD where ultrasound assisted in diagnoses. These individuals had difficulty swallowing and abnormal sensations in the tongue, which remained undiagnosed until we performed ultrasound of oropharynx which allowed for characterization of these movements.

Ultra High-Frequency Ultrasound of Median Nerve Fascicles at the Wrist in Amyotrophic Lateral Sclerosis: An Exploratory Study.

Purpose: High-frequency ultrasound (HFUS) of muscle and nerve has the potential to be a reliable, responsive, and informative biomarker of disease progression for individuals with amyotrophic lateral sclerosis (ALS). High-frequency ultrasound is not able to visualize median nerve fascicles to the same extent as ultra-high-frequency ultrasound (UHFUS). Evaluating the number and size of fascicles within a nerve may facilitate a better understanding of nerve diseases.

Muscle ultrasound as a key in assisting the diagnosis of neuromyotonia.

Neuromyotonia or Isaacs syndrome is a rare neuromuscular disorder secondary to hyperexcitable peripheral nerves which fire continuously causing motor unit activation and manifests clinically as cramps, muscle twitches, or visible muscle contraction associated with impaired muscle relaxation. Clinical suspicion and subsequent diagnostic work-up, including electrophysiology, aid in the diagnosis. However, when contractions are not appreciated clinically, there is a high possibility of misdiagnosis.

Determining the degree of proximal nerve fascicle rotation in healthy controls using ultrahigh-frequency neuromuscular ultrasound: A pilot study.

Introduction/aims: Ultrahigh-frequency ultrasound (UHFUS) allows improved visualization and higher resolution images of nerve fascicles than standard high-frequency ultrasound. Dynamic UHFUS may detect the presence of fascicular entwinement, the recently described sonographic phenomenon of pathologic fascicular rotation seen in neuralgic amyotrophy. This pilot study aims to establish normative reference values and degrees of fascicular rotation for the proximal portions of commonly involved upper limb nerves in healthy controls using UHFUS.

The Role of Neuromuscular Ultrasound in the Diagnosis of Peripheral Neuropathy.

The classification of peripheral neuropathies has traditionally been based on etiology, electrodiagnostic findings, or histopathologic features. With the advent of modern imaging, they now can also be characterized based on their varied distribution of imaging findings. We describe the major morphologic patterns of these changes, which include homogeneous enlargement; homogeneous thinning; focal, multifocal, and segmental enlargement; and focal thinning and beading (multifocal thinning).

Nerve ultrasound in amyotrophic lateral sclerosis: systematic review and meta-analysis.

Background/ Aim: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting upper and lower motor neurons, causing progressive atrophy of muscles, hypertonia, and paralysis. This study aimed to evaluate the current evidence and effectiveness of ultrasound in investigating nerve cross-sectional area (CSA) of peripheral nerves, vagus and cervical roots in those with ALS compared with healthy controls and to pool the CSA measurements.

Methods: A systematic search was conducted on Cochrane, Clarivate Web of Science, PubMed, Scopus, and Embase for the mesh terms nerve, ultrasonography, and amyotrophic lateral sclerosis.

Stakeholders' Perspectives on Current Issues in Data Monitoring Committees.

Data Monitoring Committees (DMCs) are groups of experts that review accumulating data from one or more ongoing clinical studies and advise the Sponsor regarding the continuing safety of study subjects along with the continuing validity and scientific merit of the study. Although DMCs are widely used, considerable variability exists in their conduct. This paper offers recommendations, derived from sessions given at the 2023 Central European Network International Biometric and Statisticians in the Pharmaceutical Industry Conferences' and the authors' experiences.

A Case of Suspected Carpal Tunnel Syndrome: Ultrasonography Prior to the Scalpel.

Carpal tunnel syndrome (CTS) is the most prevalent focal mononeuropathy worldwide and is traditionally diagnosed based on clinical history, examination, and nerve conduction studies. Surgical release is the gold standard in cases where conservative management fails; however, it is prudent to obtain imaging before planning such intervention. We present the case of a 47-year-old woman who presented with typical symptoms of CTS, which was confirmed with nerve conduction studies and was being considered for carpal tunnel release surgery.

Pre-vaccination transcriptomic profiles of immune responders to the MUC1 peptide vaccine for colon cancer prevention.

Self-antigens abnormally expressed on tumors, such as MUC1, have been targeted by therapeutic cancer vaccines. We recently assessed in two clinical trials in a preventative setting whether immunity induced with a MUC1 peptide vaccine could reduce high colon cancer risk in individuals with a history of premalignant colon adenomas. In both trials, there were immune responders and non-responders to the vaccine.

Ultra high-frequency ultrasound of fascicles in the ulnar and radial nerves.

Introduction/aims: Ultra high-frequency ultrasound (UHFUS) has been demonstrated to allow easy visualization and quantification of median and digital nerve fascicles; however, there is a lack of normative data for other upper limb nerves. The purpose of this study was to use UHFUS to establish normative reference values and ranges for fascicle count and density within selected upper extremity nerves.

Methods: Twenty-one healthy volunteers underwent sonographic examination of the ulnar, superficial branch of the radial, and radial nerves on one upper limb using UHFUS with a 48 MHz linear transducer.

Clinical Utility and Diagnostic Yield of Genetic Testing for Inherited Neuromuscular Disorders in a Single, Large Neuromuscular Center.

Background And Objectives: Most published studies on the clinical utility of genetic testing for neuromuscular diseases (NMDs) focus on disease-specific cohorts and/or involve multiple centers. The aim of this study was to examine the clinical utility and diagnostic yield of genetic testing at a single, large neuromuscular center. Unlike previous studies, this study is unique in that it includes a broad array of patients at a single, large neuromuscular center, providing real-world data that may assist both neuromuscular specialists as well as general neurologists in decision-making regarding the need for genetic testing in patients with suspected NMDs.

Neuromuscular Ultrasound in Polyneuropathies.

Neuromuscular ultrasound is a painless, radiation-free, high-resolution imaging technique for assessing the peripheral nervous system. It can accurately depict changes in the nerves and muscles of individuals with neuromuscular conditions, and it is therefore a robust diagnostic tool for the assessment of individuals with polyneuropathies. This review will outline the typical ultrasonographic changes found in a wide variety of polyneuropathies.

Ultrahigh-frequency ultrasound of fascicles in the common fibular, superficial fibular, and sural nerves.

Introduction/aims: While ultrasound assessment of cross-sectional area and echogenicity has gained popularity as a biomarker for various neuropathies, there is a scarcity of data regarding fascicle count and density in neuropathies or even healthy controls. The aim of this study was to determine whether fascicles within select lower limb nerves (common fibular, superficial fibular, and sural nerves) can be counted in healthy individuals using ultrahigh-frequency ultrasound (UHFUS).

Methods: Twenty healthy volunteers underwent sonographic examination of the common fibular, superficial fibular, and sural nerves on each lower limb using UHFUS with a 48 MHz linear transducer.

Evaluation of Serum Neurofilament Light Chain and Nerve Ultrasound in Diabetic Neuropathy.

Objective: To assess the role of serum neurofilament light chain (NfL) levels in individuals with diabetic polyneuropathy (DPN) compared with controls, as well as to highlight the different sonographic changes in DPN and determine if NfL correlates with sonographic, clinical, and functional parameters.

Methods: Diabetic individuals with signs or symptoms consistent with peripheral nerve involvement were recruited. They were evaluated by examination, functional neuropathy severity scores, laboratory assessments (including NfL), nerve conduction studies (NCS), and ultrasound.

A case series evaluating patient perceptions after switching from nusinersen to risdiplam for spinal muscular atrophy.

Introduction/aims: In 2016, nusinersen became the first disease-modifying medication approved by the U.S. Food and Drug Administration (FDA) for spinal muscular atrophy (SMA).

Neuromuscular ultrasound in leprosy: A scanning protocol.

The diagnosis of leprosy neuropathies has been traditionally based on clinical findings and electrodiagnostic studies, but ultrasound has emerged as a new tool for use in clinical practice. We conducted a literature search on the subject and developed a pragmatic ultrasound scanning protocol for patients with confirmed or suspected leprosy neuropathy. We suggest scanning the ulnar, median, superficial radial, common fibular and sural nerves at specific sites and assessing cross-sectional area, vascularity, and epineural thickness.

Exploration of Neurofilament Light Chain and Nerve Ultrasound in Leprotic Neuropathy.

Objectives: To explore neurofilament light chain (NfL) levels in leprotic neuropathy compared to controls, and to determine if the changes correlate with ultrasonographic nerve findings.

Methods: Individuals with leprosy with signs or symptoms suggestive of peripheral nerve involvement were recruited. They were evaluated by clinical examination, functional scores, laboratory assessments (including NfL), nerve conduction studies (NCS), and ultrasound.