Neuromuscular Ultrasound in Correlation to Neurophysiological Findings

Neuromuscular Ultrasound Changes in Neuropathies in Correlation to Neurophysiological Findings

1. Study the neuromuscular ultrasound findings in different types of neuropathies
2. correlation between ultrasound and neurophysiological findings in peripheral nerve diseases
3. correlation between clinical pain scale and severity of neuropathy

Study Overview

• Status: Unknown
• Conditions: Diabetic Neuropathies; Carpal Tunnel Syndrome; Guillain-Barre Syndrome
• Intervention / Treatment: Device: ultrasound

Detailed Description

Ultrasonography is a diagnostic tool that is increasingly used in the work-up of peripheral nerve disease.

As many peripheral nerves run a superficial course, especially in the arms. This is a big advantage over Magnetic Resonance Imaging that is relatively expensive, time consuming and not readily available everywhere.

Nerve cross-sectional area (CSA) can be determined at multiple sites along the nerve.

CSA can be measured at entrapment sites but also at nonentrapment sites. vascularization, echogenicity, fascicular pattern and endoneurial thickness can be investigated as well. All those modalities can give critical insight in the origin and development of various peripheral neuropathies1,2,3

Major peripheral nerves in the extremities, such as the median,ulnar thick enough to reflect the sound beam, resulting in hyperechoic on the US scan 4.

The correlation between nerve conduction study parameters and CSA in ultrasound Ultrasound of the peripheral nervous system is an additional useful diagnostic tool in neuromuscular disorders..5,6,7,8,9 In the longitudinal plane, nerves present as long, slim structures with a mixture of parallel hypoechoic and hyperechoic lines.

Nerves must be distinguished from other nearby structures to ensure correct identification Muscles are hypoechoic and interspersed with small hyperechoic foci which easily distinguishes muscles from nerves. Tendons, which are sometimes adjacent to nerves, move proportionately with joint movement.

US has higher specificity than sensitivity in differentiating myopathic and neuropathic changes The most sensitive diagnostic marker for symptomatic carpal tunnel syndrome patients is an enlarged crosssectional area of the median nerve 10,11,12

• Study Type: Observational
• Enrollment (Anticipated): 100

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Setting:in assuit university hospitals, neuropsychiatry hospital,neurology, orthopedic ,and internal medicine outpatients clinics subjects:will include two groups : peripheral nerve diseases group and healthy control group

Description

Inclusion Criteria:

• above 18 years old
• males or females
• diabetic complaining of neuropathy or not
• carpal tunnel syndrome
• Guillain-Barré syndrome

Exclusion Criteria:

• Patient refuse to participate
• The anatomy is altered due to sever trauma,tumor,or surgery
• Severe spasticity preventing examination

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
diabetic complaining of neuropathy or not; using of ultrasound in examination and nerve conduction study	Device: ultrasound; easy new non invasive tool; Other Names: ultrasonography
carpal tunnel syndrome; using of ultrasound in examination and nerve conduction study	Device: ultrasound; easy new non invasive tool; Other Names: ultrasonography

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Nerve ultrasound	on median and ulnar nerves	3 years
muscle Ultrasound	on thenar and hypothenar muscles	3 years
nerve conduction studies	for median and ulnar nerves (sensory and motor)	3 years
Electromyogram	for thenar and hypothenar	3 years

Collaborators and Investigators

• Sponsor: Assiut University

Study record dates

Study Major Dates

• Study Start (Anticipated): October 1, 2019
• Primary Completion (Anticipated): October 1, 2022
• Study Completion (Anticipated): November 1, 2022

Study Registration Dates

• First Submitted: September 14, 2019
• First Submitted That Met QC Criteria: September 14, 2019
• First Posted (Actual): September 17, 2019

Study Record Updates

• Last Update Posted (Actual): September 19, 2019
• Last Update Submitted That Met QC Criteria: September 17, 2019
• Last Verified: September 1, 2019

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Nervous System Diseases; Immune System Diseases; Autoimmune Diseases of the Nervous System; Demyelinating Diseases; Autoimmune Diseases; Wounds and Injuries; Endocrine System Diseases; Disease; Diabetes Complications; Diabetes Mellitus; Neuromuscular Diseases; Mononeuropathies; Peripheral Nervous System Diseases; Median Neuropathy; Nerve Compression Syndromes; Cumulative Trauma Disorders; Sprains and Strains; Polyradiculoneuropathy; Polyneuropathies; Syndrome; Carpal Tunnel Syndrome; Diabetic Neuropathies; Guillain-Barre Syndrome
• Other Study ID Numbers: ultrasound in neuropathies

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No