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

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology Pub Date : 2025-05-19 DOI:10.1016/j.clinph.2025.2110749

Luciana Pelosi , Zsuzsanna Arányi , Daniele Coraci , Alexander Grimm , Ingrid Herraets , Lisa D. Hobson-Webb , Antonios Kerasnoudis , Ruth Leadbetter , Simon Podnar , Neil Simon , Johan Telleman , Nens van Alfen , Leo Visser , Francis O. Walker , Natalie Winter , Eppie M. Yiu , Craig Zaidman , Michael S. Cartwright

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Abstract

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.

The panel agreed that NMUS should be used if EDX cannot differentiate an axonal from a demyelinating process or an acquired from a hereditary process, and in the investigation of vasculitic neuropathy; NMUS of the brachial plexus should be used in Guillain-Barre’ syndrome if EDX is negative; when NMUS is used, at least two nerves of the upper limbs should be scanned; NMUS should be used for screening or repeat testing for carpal tunnel syndrome in children with mucopolysaccharidoses.

Areas of disagreement exposed gaps in current knowledge and informed the direction of future research, which should aim to identify situations in which NMUS can stand alone as a diagnostic test, particularly for screening or repeat testing and especially in vulnerable individuals and paediatric populations.

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专家对多神经病变联合电诊断试验和神经肌肉超声检查的共识

17位被提名的全球专家领导人就神经肌肉超声（NMUS）和电诊断试验（EDX）在临床实践中周围神经病变（PN）调查中的联合使用提供了共识。共识是基于专家自己对文献的初步系统回顾，然后是三次匿名调查，使用德尔菲法。没有共识被定义为<；60%额定频率。专家组一致认为，如果EDX不能区分轴突与脱髓鞘过程或获得性与遗传过程，则应使用NMUS，并用于血管血管性神经病的调查；如果EDX阴性，在格林-巴雷综合征中应采用臂神经丛NMUS；使用NMUS时，至少要扫描两条上肢神经；粘多糖病患儿腕管综合征应采用NMUS筛查或重复检测。分歧的领域暴露了当前知识的差距，并为未来的研究指明了方向，其目标应该是确定NMUS可以单独作为诊断测试的情况，特别是用于筛查或重复测试，特别是在脆弱个体和儿科人群中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurophysiology 医学-临床神经学

CiteScore

8.70

自引率

6.40%

发文量

932

审稿时长

59 days

期刊介绍： As of January 1999, The journal Electroencephalography and Clinical Neurophysiology, and its two sections Electromyography and Motor Control and Evoked Potentials have amalgamated to become this journal - Clinical Neurophysiology. Clinical Neurophysiology is the official journal of the International Federation of Clinical Neurophysiology, the Brazilian Society of Clinical Neurophysiology, the Czech Society of Clinical Neurophysiology, the Italian Clinical Neurophysiology Society and the International Society of Intraoperative Neurophysiology.The journal is dedicated to fostering research and disseminating information on all aspects of both normal and abnormal functioning of the nervous system. The key aim of the publication is to disseminate scholarly reports on the pathophysiology underlying diseases of the central and peripheral nervous system of human patients. Clinical trials that use neurophysiological measures to document change are encouraged, as are manuscripts reporting data on integrated neuroimaging of central nervous function including, but not limited to, functional MRI, MEG, EEG, PET and other neuroimaging modalities.